3AS1C PATH 



OLOC 



IFIC TREATMENT 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES 



LIBRARY OF CONGRESS 




OOOIOQH^ 42 



LIBRARY OF CONGRESS. 



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UNITED STATES OF AMERICA. 



THE 

BASIC PATHOLOGY 



AND 



SPECIFIC TREATMENT 



OF 



DIPHTHERIA, TYPHOID, ZYMOTIC, SEPTIC, 

SCORBUTIC, AND PUTRESCENT 

DISEASES GENERALLY. 



BY 



GEO. J. ZIEGLER, M. E> 



Late Physician to the Philadelphia Hospital; Member of the Philadel- 
phia County Medical Society, of the American Medical Association, 
etc. Author of " Zoo-adynamia," " Researches on Nitrous 
Oxide," "Natural Laws of Marriage," etc. 



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>ioyo~G 



PHILADELPHIA : 

O- BO. T- ZIEG-LEE, ZMI. ID. 
1884. 



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v^ 



Entered according to Act of Congress, in the year 1883, by 

GEO. J. ZIEGLER, M. D., 

In the Office of the Librarian of Congress, at Washington, D. C. 



PREFACE 



In the following pages I have endeavored to present 
a general summary of the basic pathology and specific 
treatment of some of the most formidable and destructive 
diseases that afflict and destroy mankind and the lower 
animals, for they are directly linked in one continuous 
pathological as well as physiological chain of life. I 
have therein tried to show that all the varied and com- 
plex diseases classed as scorbutic, necrsemic, typhoid, 
zymotic, septic, infectious, malarial, gangrenous, pu- 
trescent, and allied affections, by whatever name desig- 
nated, from the simplest to the most malignant, are 
dependent upon, or complicated with, one common 
basic, alkaline, pathogenic factor, mostly the volatile or- 
ganic alkali — Ammonia, incidental to all forms of life, 
and differing only in quantity and the constitutional 
and local manifestations and complications arising from 
diverse aetiological and pathological conditions, yet 
underlying and intensifying them all, and thus often 
complicating and rendering more severe every form 
of disease, even of the simplest kind, for the successful 
treatment of which, this primal morbific factor must 
be decomposed, neutralized, or removed, which can 
usually be readily effected by acidulous, antalkaline, 
resolving, and counteracting agents, thus simplifying 
the hygienic and therapeutic problems in general, and 
giving more definiteness and certainty to sanitation 
and therapeutics, or both preventive and curative 
medicine. 

(3) 



Thus, the recognition and subversion, or neutraliza- 
tion and elimination of this one common alkaline 
factor of disease, pestilence, and death, inherent in the 
vital economy, as well as derived from extraneous 
sources, cannot fail to improve the health and greatly 
facilitate the prevention and resolution or cure of 
disease of all kinds, especially those typhoid, septic, 
zymotic, contagious and malignant maladies directly 
occasioned thereby, that so largely endanger and de- 
stroy the lives of human beings and the inferior 
creatures. With the special agents for this purpose, 
I have also briefly considered its collateral relations and 
morbific complications, with the particular remedies 
and measures indicated for the prevention and treat- 
ment of these diseases, both simple and complex. 

I have thus embodied in general, the results of my 
own observations, experience, and studies thereon, with 
confirmatory evidence from other sources, believing 
them to be correct and in direct accord with science 
and truth. But as individual observation, experience, 
and effort are necessarily limited, I present them for 
the serious consideration of the medical profession, 
and the severest practical test to which they can be 
put in every way in hospitals and sanitaria for the 
sick, as well as in private practice, and in quarantine, 
and elsewhere throughout the world, for preventive 
and curative purposes ; believing that both directly 
and indirectly their practical application will result in 
great good in the prevention and cure of some of the 
most malignant and devastating diseases, with the 
minor "ills to which flesh is heir," that so sorely 
scourge and destroy human beings with the inferior 
forms of life. 



As it would, of course, require a large volume to 
treat of these subjects in extenso, I have merely pre- 
sented a general outline of the main points and basic 
principles of the most practical importance in a hy- 
gienic and therapeutic point of view, to more directly 
concentrate attention thereon and better enable sanita- 
rians and physicians to avert, counteract, and resolve 
these morbific plagues with their concomitant evils. 

Philadelphia, November 15, 1883. 



CONTENTS. 



Page 

Preface, 3 

I. Introduction, 7 

II. J3TIOLOGY AND PATHOLOGY, 11 

III. Treatment, 70 

IV. External Treatment, 157 

V. Prevention, 161 

VI. Conclusions, 194 



THE 

BASIC PATHOLOGY 



AND 



SPECIFIC TREATMENT 



OF 



Diphtheria, Typhoid, Zymotic, Septic, Scorbutic, 
Putrescent, and Mephitic Diseases Generally. 



I. 

INTRODUCTION. 

The treatment of diphtheria, typhoid, zymotic, 
scorbutic, septic, putrescent and correlative diseases, 
like all other morbid states, must necessarily be based 
upon their basic and true pathology, and although a 
knowledge of this is most desirable for the greatest 
certainty in the application of remedial measures, 
yet, independent thereof, much practical information 
of therapeusis may be acquired by enlightened obser- 
vation, experiment, and practice, as well as the more 
purely empirical and tentative treatment, or the 
casual juvantia and lsedentia, especially if supple- 
mented with logical induction and deduction, and this 
too, even when the aetiology and pathology of any 
disease is most obscure and undetermined, as shown 
for instance, in the empirical discovery of the very 
general specific effects of cinchona bark with its prin- 
cipal alkaloid, quinia, in the prevention and cure of 

m 



BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

intermittent and other malarial fevers, though the 
materies morbi and pathology thereof are so indefinite 
and occult. 

The same holds true in diphtheria with other zymotic 
and septic diseases, for though their precise aetiology 
and pathology may not be fully known, yet a definite 
amount of information thereon has been practically 
acquired, while clinical experience teaches certain 
truths with regard to their successful treatment based 
upon scientific principles and practice as well as em- 
pirical effort and unenlightened observation, so that 
these latter are not to be entirely disregarded, as they 
sometimes afford valuable data for accurate induction 
and correct treatment. But in the meantime, while 
the exact aetiology, pathology and treatment of these 
formidable diseases are still so largely sub judice, 
reasoning in a scientific spirit, based upon personal 
and professional, with general observation and ex- 
perience, cannot fail to greatly aid in the solution of 
these truly vital problems. 

In scientific medicine theory precedes and directs 
practice; while in empirical effort practice precedes 
intelligent thought, and is but tentative and experi- 
mental at the best, as it can only prove accidentally 
useful and of most value when carefully conducted 
in an inductive spirit, but if at random, without due 
discretion and judgment, will ensue in hap-hazard and 
destructive rather than in beneficent results. Hence, 
the most extensive experience without due thought 
and reflection is but reckless empiricism and usually 
more injurious than beneficial, for truly "if experi- 
ence is not directed by theory it is blind," says Bacon, 
and necessarily more or less confusing if not mislead- 
ing, as is often exemplified in the empirical treatment 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 9 

of disease and all other matters. Indeed, purely em- 
pirical experience is like a lamp without a light, it is 
an inert or dead fact that has the basis but not the 
principle of light within it, yet which when lighted 
illuminates everything around it and enables those 
that can see to direct their work and movements with 
the greatest precision and certainty, instead of other- 
wise floundering about in the dark tentatively and 
often injuriously or even destructively to themselves, 
things and persons about them. Thus theory is a 
light and compass that enlightens and directs practice, 
and establishes a scientific and positive, for an empiri- 
cal and doubtful art of hygiene and therapeutics in 
the prevention and treatment of disease. In fact 
then, for scientific accuracy and positive certainty, 
theory, thought or deduction must precede practice 
in medicine as in every other branch of knowledge 
having the slightest claims to the title of science and 
scientific art; pure empiricism being but a series of 
blind or random experiments that maims and kills 
oftener than cures, and long before even logical in- 
duction will guide to correct practice. Indeed, it is 
only by the union of the two co-ordinate systems of 
induction and deduction that the highest results can 
be secured so as to develop a true science and art of 
medicine — culminating in hygiene and therapeutics, 
the ultimate expression thereof. Legitimate deduc- 
tion will as surely lead aright to correct conclusions, 
practice, and discoveries in medicine as it directed 
Leverrier to the knowledge and discovery of a new 
planet, and it matters not whether the medical any 
more than the astronomical discoverer is the practical 
demonstrator of his own cognitions, the truth and 
honor are the same in either instance. Hence, from 

B 



10 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

facts to principles, and from theory to practice, should 
be the rule in medicine as in all other branches of 
science, to insure a scientific art of sanitation and 
rational methodus medendi, or true system of preventive 
and curative medicine. 

But as in general, both inductively and deductively, 
individual thought, investigation and experience must 
necessarily be limited, it is usually far better to regard 
the combined observations, experience, experiments, 
and cognitions of the many as most apt to lead to correct 
conclusions and practice. Therefore, taking as a basis 
the observations, experience and knowledge in general, 
with my own limited investigations and cognitions 
thereon, I venture to present the following views 
respecting the aetiology, pathology, prevention and 
treatment of diphtheria, typhus, cholera, zymotic, 
septic, infectious, scorbutic, putrescent, mephitic, colli- 
quative and cognate diseases generally, believing them 
to be founded upon truth and the immutable laws of 
nature, hence must necessarily be correct and successful 
in the degree that they are properly applied. With a 
view then to a clearer exposition of the specific means 
for the prevention and treatment thereof, I will first 
briefly present a general outline of the basic source 
and proximate — if not often the immediate — cause of 
these destructive maladies as manifested in their 
etiology and pathology, from the standpoint of my own 
observations, experience and studies, with confirma- 
tory evidence from other sources. 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES, 11 

II. 

ETIOLOGY AND PATHOLOGY. 

While in general, abnormal departures from the 
normal standard of health are spontaneous from 
various non-specific intrinsic and extraneous causes, 
in some there are more immediate special exciting 
influences or specific contagia, vet in all these varied 
though correlative maladies there seems to be one 
common basic morbific factor, promotive of the incep- 
tion and malignancy of the diverse scorbutic, zymotic, 
septic, putrescent, contagious, colliquative, adynamic 
and cognate diseases generally, both constitutional 
and local. This may be engendered within or be in- 
troduced from without the vital economy, or be ab- 
normally increased therein by both. It is of an 
alkaline nature, resulting from general organic trans- 
formation and decomposition in both plants and 
animals, and without which the specific contagium 
or exciting cause in each case, whatever it may be, 
could not develop and act upon the living organism 
with such intensity and deadly effect as usual in 
zymotic, infectious and septic diseases, while in some 
it may be the sole pathogenic factor developing 
spontaneously various scorbutic, toxic, putrescent 
and adynamic diseases of a milder type which are, 
however, the basis of the more malignant and con- 
tagious diseases, the intensity, variety and complica- 
tions thereof depending upon its quantity. It is thus in 
fact a veritable fons et origo mali, and gives the type of 
malignancy to all diseases, local as well as general. 
This is strikingly manifested in scurvy, purpura, 



12 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

necrseniia and typhus, as well as in all other septic 
and infectious diseases arising from the ordinary 
conditions of life, notably erysipelas, which may be 
idiopathic or be excited by the slightest bruise or 
scratch whenever the susceptibility or superalkaline 
condition of the blood and system exists. This is 
likewise the case in ship, and doubtless also in yellow, 
congestive, malarial, and all other malignant fevers, 
with diphtheria, the exanthemata and the scorbutic 
type, necrsemic tendency, putrid, typhoid, infectious, 
and dissolutive crasis of diseases generally, as all the 
symptoms thereof point to this general basic superal- 
kaline condition of the blood and economy, while 
investigation has demonstrated it to a certain extent. 
This common basic morbific alkaline agent of all 
such diseases is the well-known organic alkali — 
Ammonia, which is being constantly engendered 
spontaneously within the living organism from the 
combination of its constituent elements in the chemi- 
cal reactions and normal disintegration of the com- 
ponents of the body, and often in excess from heat, 
undue effort and other active causes of organic 
decomposition, as well as excessive accumulation 
therein from its abnormal retention within the vital 
economy. It may also be more or less freely 
introduced from without the system by imbibition 
in impure water, and the direct inhalation of its vapor 
extraneously engendered, or its evolution from various 
malarious, decomposing and putrefying substances, as 
it is highly volatile, especially when influenced by 
heat and moisture, which are so active in tropical 
climates and warm weather, and in close, hot and 
moist places everywhere. 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 13 

Thus, in general, in all these varied scorbutic, 
typhoid, zymotic, septic, pyretic, malarial, infectious, 
putrescent, colliquative, and allied diseases, there is 
this one common basic, underlying and omnipresent 
morbific factor of an excess of the volatile organic 
alkali — Ammonia, either generated or retained unduly 
within, or introduced from without the body, or all 
combined according to circumstances, of itself en- 
gendering and superinducing a scorbutic, necrsemic, 
colliquative, pyrexial, phlegmonous, typhoid, mephitic, 
infectious, and malignant type of disease. This am- 
monsemia or superalkaline condition of the blood and 
system, thus induces an undue solution and fluidity 
of the liquids, and softening of the solids of the body, 
with scorbutic, necraemic, toxic, septic, phlogistic, 
febrile, contagious, adynamic, and decomposing con- 
ditions, and tendency to serous and albuminous states 
and defluxions, congestions, haemorrhages, inflamma- 
tions, eruptions and other local lesions, as well as con- 
stitutional disorders of a mixed sthenic and asthenic 
type, and of a putrescent, infectious, gangrenous, dis- 
solving and disorganizing character, especially mani- 
fested in typhus, ship, yellow, congestive, bilious, 
enteric, puerperal and other low fevers, with small-pox, 
scarlatina, measles, diphtheria, angina maligna, apthae 
and gangrene of mouth, throat, lungs and other parts, 
anthrax and carbunculoid affections, erysipelas, in- 
flammation and abscess of liver, haematemesis, hema- 
turia, albuminuria, anasarca, lencorrhoea, diarrhoea, 
choleraic, suppurative, and other serous, haemorrhagic, 
lymphoidal, catarrhal and purulent fluxes, with ady- 
namic, febrile and malignant forms of typhoid, zymotic, 
septic, contagious, mephitic and colliquative diseases 



14 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

generally, which are specially manifested according to 
complicating circumstances. 

That this ammoniacal and superalkaline condition 
of the blood and system is a potent underlying mor- 
bific factor, and an active exciting, as well as predis- 
posing cause of all such diseases is manifest from all 
their correlative phenomena and general nature, 
though it has also been largely demonstrated by obser- 
vation and experience, as well as by practical thera- 
peutics, a brief outline of which I will present in 
confirmation thereof, with a view to their direct 
application to the prevention and curative treatment 
of these toxical, disorganizing, contagious, pestiferous, 
and destructive maladies, with the minor scorbutic and 
mephitic disorders. 

Thus, according to Dr. Waring {Practical Therapeutics), 
"Hufeland observes that the officinal and probably all 
the salts of ammonia have the property to a greater 
or less degree of dissolving the blood-corpuscles, 
although slowly, and the protean textures generally. 
When blood is combined w r ith an ammoniacal salt, it 
acquires generally a brighter red, but this soon passes 
into a brownish red hue; it does not coagulate, but 
forms at best, a loose semifluid cruor, the corpuscles 
begin to disappear, and the whole becomes more limpid. 
Blood thus decomposed, progressively evolves distinct 
traces of ammonia. It is very probable that we may 
partially explain, upon chemical grounds (solution and 
disengagement of ammonia), why large doses of 
hydrochlorate of ammonia act as poisons, and smaller 
doses, long continued, induce a scorbutic condition. 
Yet the same salt, judiciously exhibited, furnishes a 
valuable stimulant to the secretory and excretory 
apparatus. That chemical attraction is inadequate to 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 15 

account for the therapeutic and poisonous quality of 
the hydrochlorate is obvious, inasmuch as it exercises 
a general action, and induces inflammation of the 
stomach even when introduced into the subcutaneous 
cellular tissue. 

" Dr. B. W. Richardson has confirmed the statement 
that the effect of the addition of ammonia to freshly 
drawn blood, is to prevent coagulation, and to destroy 
and alter the blood globules. In this respect the action 
of ammonia resembles that of the fixed alkalies. When 
ammonia or its carbonate is administered for some 
time to animals or man, the effect is to modify the 
blood-corpuscles; they become easily soluble, crenate 
at the edge, many-sided, colorless, transparent, col- 
lapsed, and loosely agglomerated, but not in rolls; and 
the blood when drawn, or after death, is absolutely 
fluid or loosely coagulated. These changes in the 
blood, he thinks, correspond closely with those ob- 
served by Jenner in the blood of patients suffering 
from typhus fevers. By making animals breathe or 
swallow ammonia, Dr. Richardson has been able to 
induce a condition resembling the typhoid in man. 
A superalkaline condition of the blood from the 
presence of an excess of ammonia is observed in yellow 
and typhus fevers, and other diseases of the typhoid 
type, and in cases where the function of the kidney is 
suppressed. In such conditions, therefore, he believes 
that the administration of ammonia and other alkalies 
is contraindicated. The ammoniacal condition of the 
blood is recognized by the ammoniacal condition of 
the breath, tested by a rod dipped in hydrochloric 
acid/' 

But, better still, even before ammonia can be thus 
detected in the breath by the scorbutic condition of 



16 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

the blood itself, and the general appearance of the 
tongue and lips, or mucous membrane- of the interior 
of the mouth, which have a diffused reddish-brown, 
purplish or dark cerulean hue, as if the blood was 
imcornpletely oxidized, and the red corpuscles collapsed 
with their coloring matter diffused through the serum. 
This ammoniacal or superalkaline condition of the 
blood is also often manifest in the countenance and 
general surface of the body, especially in the hands 
and feet, sometimes to a very marked degree, though 
a similar scorbutic state may likewise result from an 
excess of the fixed alkalies, particularly from potassium 
and its salts. 

Moreover, Dr. Richardson found that "the presence 
of ammonia effectually arrested the oxidation of various 
substances, and even prevented the action of ozone. 
Believing that by an extension of the same law, 
animal substances exposed to ammonia could be pre- 
vented from putrefaction, he kept blood and portions 
of tissues in contact with simple ammoniacal vapor, 
and with results which were most remarkable. Blood 
in an ordinary stoppered bottle, if charged with 
ammonia so as to give a faint ammoniacal odor, would 
retain its freshness and many of its properties for years. 
Animal structures in like manner placed, even so as to 
be massed together in bottles containing ammonia 
vapor, would retain their freshness apparently for an 
unlimited time 

11 The last point to which Dr. Richardson drew 
attention was the cause of the antiseptic power of 
ammonia. Ammonia, being a product of decomposi- 
tion, had been looked on commonly as a substance 
provoking decomposition. But ammonia was truly 
the most powerful antiseptic known ; it acted catalyti- 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 17 

cally, by preventing the action of oxygen with oxidi- 
zable bodies. . . . . . 

" In conclusion, the results presented tended to throw 
a light on the influence of the ammonia, as the pro- 
ducing causes of some diseases, and as the curative 
remedies in other diseases. The same rule that per- 
tained to dead pertained to living organic matter. 
Hence, long exposure to ammoniacal vapor, by 
arresting oxidation, produced extreme anaemia and 
a low depraved condition of the system altogether, 
with reduced respiration, reduced appetite, reduced 
muscular power, and reduced energy. On the other 
hand, in cases where a rapid oxidation of the body was 
being determined, attended with increase of heat and 
rapid disintegration of tissue, the administration of 
ammonia, by arresting these changes, became, in 
judicious hands, the most powerful and effective of 
remedies. It checked decomposition by its action on 
oxygen ; it held the blood fluid by its solvent power 
as an alkali; and, being volatile, it inflicted no imme- 
diate injuries on the structures of the body." — British 
Medical Journal and Dublin Medical Press. 

Yet, ammonia in excess is a powerful caustic and 
irritant, as well as solvent, while its volatility dissemi- 
nates it rapidly throughout the system, dissolving and 
disintegrating the blood corpuscles, exciting, irritating 
and inflaming the heart and vessels with all the other 
organs and structures of the body, disorganizing the 
fluids and solids of the vital economy, and actively 
promoting dissolution and death as often manifested 
in ammoniacal and stinking blood, urine and other 
fluids, with corresponding abnormities, so that for 
medicinal purposes it has to be given carefully in 
moderate doses. Hence, while it may preserve dead 



18 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

animal structure, it devitalizes living tissue, and dis- 
orders and arrests life action. As the presence of 
ammonia in excess prevents due oxidation of the 
living as well as dead blood and tissues, it thereby in 
the proportion of its accumulation or quantity in the 
body, subverts normal arterialization, hsematosis, nu- 
trition and chemico-organic or vital metamorphosis 
generally, while by its solvent, irritant, and volatile 
properties, it causes abnormal liquefaction, excitement, 
deterioration and disorder of the components, struct- 
ure and functions of the living organism, thus predis- 
posing and giving rise to numerous and varied diseases 
of a mixed inflammatory, septic, infectious and ady- 
namic character, both constitutional and local, accord- 
ing to concurring and complicating circumstances, so 
frequently manifested in typhus, yellow, puerperal, 
enteric and other asthenic fevers, diphtheria, angina 
maligna, erysipelas and correlative phlegmasia, w^ith 
haemorrhages, albuminous, serous, choleraic and other 
defluxijus, mephitic, malignant, infectious, and colli- 
quative diseases generally. 

Besides the constant spontaneous evolution of 
ammonia in the body from the direct union of its 
elements in the normal chemico-organic processes of 
the living economy, it may be, and often is, abnor- 
mally increased by undue retention therein, as well as 
by various inherent and extraneous agencies, until a 
state of ammonsemia ensues, which, according to its 
degree of intensity and concurring circumstances of 
climate, season, weather, temperature, moisture, pesti- 
lential and other agencies, occupation, exposure, 
alimentation, conditions, habits and modes of life, 
becomes an active predisposing and exciting cause of, 
with the minor ills, some of the most malignant and 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 19 

pestiferous diseases that afflict and destroy mankind 
with the lower forms of life. 

Thus, in addition to its internal chemico- vital sour c :- - , 
ammonia may be introduced from without the 
by imbibition or inspiration from decomposing organic 
matter, or from its artificial evolution as is bo common 
and profuse in that pernicious miasm — tobacco smoke, 
which is diffused s<:» freely everywhere throughout the 
world, on land and sea, in ships and houses, in hamlet 
and palace, city and country, indoors and outdoors, in 
every country and clime. - that scarcely any one can 
be free from its forced involuntary inhalation and 
baneful effects. Moreover, with the volatile ammoi 
therein, tobacco smoke contains those most r tent 
narcotic poisons — nicotia. nicotianin, collndine and 
other active sedatives, which also deteriorate the 
blood and depress the nervous and general system, 
thereby strongly predis] sing to, and causing ady- 
namic, scorbutic, septic, infectious, mephitic and 
colliquative diseases, to which men, women and 
children are thus so freely exj everywhere 

having their nostrils, throats, air p: ind lungs 

irritated, and their blood and bodies frequen 
saturated with the noxious fumes of tobacco, in addi- 
tion to other active causes of disease and d< :he 
separate and combined influence of which sickens, 
disables and destroys myriads of human beings. 

Tiiat tobacco is a potent acro-narcotic and prolific 
source of ammonia with other morbid and 

baneful agents, and its use or exposure _ :• its noxious 
fumes largely introduces it and them into the system, 
thereby irritating the nares, mouth, pharynx, air 
passages, lungs, and heart, corrupting the blood, 
vitiating the humors, perverting the secretions, de- 
pressing the nervous, muscular, mental, and vital 



20 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

energies, and poisoning the entire economy, ample 
evidence is afforded everywhere, and much scientific 
testimony could be adduced in proof thereof, but we 
will merely present the following of more immediate 
practical relation to the subject of discussion : 

Thus, Dr. Headland states (Action of Medicine), 
"The vapor of burning tobacco contains carbonate of 
ammonia in considerable quantity. This must neces- 
sarily be absorbed to a large extent by the mucous 
surfaces of the mouth and lungs of smokers" (and 
likewise of those obliged to inhale it). "Regarded 
in this point of view, the practice of smoking when 
continued, may be looked upon in the same light as 
a course of alkaline medication. It may be attended 
with the same risk or advantage. It must be ill- 
suited to those in whom there is a tendency to 
alkalinity of the humors, and better adapted to the 
case of those gouty or dyspeptic subjects with whom 
the contrary obtains. But of course the therapeutic 
action of the nicotia and other volatile principles of 
tobacco must be separately taken into account." (p. 143.) 

" The smoke of tobacco contains its alkaloid nicotia. 
This is a powerful poison. If it were allowed to 
accumulate in the blood the act of smoking would 
probably be fatal. It is certainly absorbed to some 
extent, but it passes quickly into the urine where it 
may be detected by simple chemical tests. Even the 
small quantity at one time in the system will produce 
a very marked intoxication in some persons. It is 
only not a poison because slowly taken into the system 
in small amounts and eliminated pari passu. Dr. Paris 
has plausibly conjectured that nicotia may be the fc juice 
of cursed Hebanon' mentioned in 'Hamlet. 5 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 21 

"The careful experiments of Dr. Snow appear to 
have established the fact that the volatile inebriants are 
powerful in inverse proportion to their solubility : also 
that whether inhaled or absorbed from the stomach 
their action obeys very closely the following law; com- 
plete narcotism is established as soon as the blood has 
dissolved one fifty-sixth part of the quantity it is 
capable of holding in solution. 5 ' (p. 269.) 

Dr. B. W. Richardson presents in the Medical Times 
and Gazette, the following summary of the noxious 
effects of tobacco: "1. The effects that result from 
smoking are due to different agents imbibed by the 
smoker, viz., carbonic acid, ammonia, nicotine, a 
volatile empyreumatic substance, and a bitter extract. 
The more common effects are traceable to the carbonic 
acid and ammonia; the rarer and more severe to the 
nicotine, the empyreumatic substance, and the extract. 
2. The effects produced are very transitory,* the 
poisons finding a ready exit from the body. 3. All 
the evils of smoking are functional in character, and 
no confirmed smoker can ever be said, so long as he 
indulges in the habit, to be well; it does not follow, 
however, that he is becoming the subject of organic 
and fatal disease because he smokes.f 4. Smoking 
produces disturbances: (a) in the blood, causing 
undue fluidity and change in the red corpuscles; (6) on 
the stomach, giving rise to debility, nausea, and, in 
extreme cases, sickness; (c) on the heart, producing 



* Sometimes, however, they are severe and and persistent ; from 
a slight exposure to the fumes of tobacco I have known them to 
continue for days and produce very serious illness and prolonged 
invalidism. 

f Although it is a frequent result thereof, as seen in cancer of 
lip, ulceration of throat, disease of heart, brain, kidney, etc. 



22 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

debility of that organ and irregular action ;* (d) on the 
organs of sense, causing in the extreme degree dilata- 
tion of the pupils of the eye, confusion of vision, bright 
lines, luminous or cobweb specks, and long retention of 
images on the retina, with other and analogous sym- 
toms affecting the ear, viz., inability clearly to define 
sounds, and the annoyance of a sharp, ringing, sound 
like a whistle or a bell ; (e) on the brain, suspending 
the waste of that organ, and oppressing it if it be 
duly nourished, but soothing it if it be exhausted; 
(/) on the nervous filaments and sympathetic or 
organic nerves, leading to deficient power in them, 
and to over-secretion in those surfaces — glands — over 
which the nerves exert a controlling force; (g) on the 
mucous membrane of the mouth, causing enlargement 
and soreness of the tonsils (smoker's sore-throat), 
redness, dryness, and occasional peeling off of the 
membrane, and either unnatural firmness or contrac- 
tion and sponginess of the gums; (Ji) on the bronchial 
surface of the lungs when that is already irritable, 
sustaining the irritation, and increasing the cough. 
5. The statements to the effect that tobacco smoke 
causes specific diseases, such as insanity, epilepsy, 
St. Vitus' dance, apoplex}^, organic diseases of the 
heart, cancer and consumption, and chronic bronchitis 
have been made without any sufficient evidence or 
reference to facts; all such statements are devoid of 
truth, and can never accomplish the object which those 
who offer them have in view.f 6. As the human body 

* With sometimes neuralgia and spasm of the heart, angina 
pectoris, paralysis, and sudden death. 

f Nevertheless, ample evidence of the truth of such could be 
adduced if space permitted, some of which we will present, with 
others the writer can testify to its production of neuralgia, in- 
sanity, organic as well as functional disease of the heart, bron- 
chitis, consumption, haemoptysis and correlative affections. 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 23 

is maintained alive and in full vigor by its capacity, 
within certain well defined limits, to absorb and apply 
oxygen, as the process of oxidation is most active and 
most required in those periods of life when the 
structures of the body are attaining their full develop- 
ment, and as tobacco smoke possesses the power of 
arresting such oxidation, the habit of smoking is most 
deleterious to the young, causing in them impairment 
of growth, premature manhood and physical degrada- 
tion," 

The evils of tobacco are not, however, thus so 
exclusively limited to the young, but extends to all 
of every age and both sexes, subject to its noxious 
influence by its use in every form and manner or 
exposure to its poisonous fumes. 

In a paper upon the subject {Georgia Medical and 
Surgical Encyclopedia), Dr. Hollified thus notices some 
of the evil effects of tobacco upon the human system. 
" Tobacco effects the system by producing weakness, 
languidness, vomiting, vertigo, stupor, giddiness, 
paralysis, nervousness, and great debility, with often 
fatal prostration. It also acts upon the nervous and 
circulatory systems to an extent that is both terrifying 
and alarming, often causing death. When chewed or 
rubbed it exerts a great influence upon the mucous 
membrane of the mouth, and also upon the salivary 
glands, the sublingual and submaxillary, causing them 
to secrete a larger amount of saliva than nature 
intended them to do, or than- is necessary for the 
purpose of accomplishing the duties assigned them, 
thus robbing the system of a portion of its fluids 
which are required for the healthy maintenance of its 
animal functions, merely for the gratification of a. 
morbid appetite. The sense of taste is generally 



24 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

perverted or greatly impaired in all those who either 
rub or chew the noxious weed. 

" When tobacco is smoked it acts as an irritant, and 
frequently a portion of the smoke is carried into the 
lungs rendering the air breathed hot and impure. It 
then acts as a sedative upon the circulation, and often 
irritates the lining membrane of the air-cells in the 
lungs, which brings on inflammation, laying broad and 
deep the seeds of disease which may in time hurry its 
victim to an early grave. Death has resulted from 
the inhalation of the smoke," and blindness has been 
occasioned by it in the case of a gentlemen addicted 
to smoking, whose sight repeatedly improved when 
he relinquished the habit. But this " was too strong; at 
last he gave way to it entirely, and in 1855 was almost 
totally blind, being only able to distinguish night from 
day, becoming according to his own acknowledg- 
ment, at the early age of twenty-eight years, a victim 
to the immoderate use of tobacco." 

If pertinent to our present purpose, much more evi- 
dence upon this latter point might be presented, but 
we can merelv refer to the following, thus : " Dr. Mack- 
enzie, in his great work on Ophthalmology, expresses 
his belief that tobacco is & frequent cause of amaurosis 
and adds, i one of the best proofs of tobacco being a 
cause of amaurosis is in the great improvement in 
vision — sometimes complete restoration — which ensues 
giving up the use of this poison,' and cites a very 
striking case in illustration. With him I agree, also, 
in the conviction that tobacco is a commou cause of 
the cases of partial loss of sight that are daily to be 
found at our hospitals." (J. C. Wadsworth, Lancet.) 

In a report on the progress of Ophthalmology for 
1867, Dr. G. Hay, of Boston, refers {Medical Archives) 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 25 

to researches by Hutchinson respecting a form of 
amaurosis supposed to be due to tobacco, published in 
the Medico-Chiurgical transactions. "The subjective 
symptoms given are dimness of vision merely; every- 
thing to him seems a fog, but he has no pain in his 
eyes, nor any photophobia or photopsia. In many 
cases the patient becomes at length absolutely blind; 
but in others the disease, having advanced to a certain 
point, is arrested. 

" The intrinsic pathological condition is atrophy of 
the optic nerve. Mr. Hutchinson observes: 'During 
the last three vears I have held it to be a bounded dutv 
to warn all who present the symptoms of this disease 
against smoking, and in only a few instances (provided 
the patient was seen early), did the disease afterwards 
progress to blindness.' Mr. Wordsworth and Mr. 
Critchett are equally positive in their opinion in regard 
to the deleterious effects of tobacco, and state that 
much smoking is the ordinary cause of the atrophy. 
Granting that a similar condition is occasioned bv 
other causes, the former, before the Hunterian Society, 
delared that he believed he could with the opthalmos- 
cope pick out smokers from non-smokers in cases of 
optic nerve atrophy. Abstinence is the cure. Mr. Crit- 
chett commits himself unhesitatingly to the opinion 
that although in many cases all medical treatment will 
be unavailing vet the abandonment of tobacco will 
arrest the further progress of the disease." 

The Medical Press and Circular states that "in a 
prize essay on tobacco, Hampton Brewer, L. R. C. P., 
London, quotes Dr. Hardwicke, Mr. Curgenven, Dr. 
Menzies, Dr. Broadbent, Mr. Hutchinson and Dr. C. 
R. Drysdale, as being convinced that tobacco smoking 
produces palpitation of the heart, impotence, in some 



26 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

cases; irregularity of bowels, congestion of the fauces, 
susceptibility to cold, dyspepsia, amaurosis, and palsy 
in some cases. We heartily agree with the author in 
his opinion as to the very injurious effects of tobacco? 
in whatever form it may be used." 

In relation to the noxious effects of tobacco smoke 
upon children, Dr. E. Decaine contributes to The Revue 
de Therapeutique Medico- Chiurgicale, February 15, 1869, 
Dublin Quarterly Journal and Half- Yearly Abstract. 
" Having described his experience in relation to this 
matter, he concludes : 1. That the pernicious effects of 
tobacco smoke upon children are incontestable. 2. It 
produces pallor, chloro-ansemia, palpitations of the 
heart, diminution of the normal number of blood glo- 
bules, and difficult digestion. 3. The ordinary treatment 
for chloro-ansemia and anaemia produces no effect so 
long as the habit of smoking is persisted in. 4. Children 
who are addicted to smoking exhibit a want of intelli- 
gence, and have a likiug more or less decided for strong 
drinks. Children who abandon the practice of smok- 
ing before any serious organic lesions are produced, 
speedily recover from disorders of the system, of which 
even traces do not generally remain." 

But comparatively few children, though many ado- 
lescents, use tobacco, yet great numbers of all ages, 
from the newly-born infant to the oldest adult, are 
more or less freely exposed to its pernicious fumes 
and noxious miasma, sufficiently to either actively 
sicken or induce a state of semi-invalidism, and 
reduce their vital power below the norme, so as to 
render them more liable to intercurrent and epidemic 
diseases, which they would otherwise escape. 

Upon the deleterious effects of tobacco, Sir Benjamin 
Brodie, thus writes in a letter to the London Times, 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 27 

republished in the Medical Times and Gazette: " The 
effects of this habit are indeed various, the difference 
depending on difference of constitution and difference 
in the mode of life otherwise. But, from the best 
observations which I have been able to make on the 
subject, I am led to believe that there are very few who 
do not suffer harm from it to a greater or less extent. 
The earliest symptoms are manifested in the derange- 
ment of the nervous system. A large proportion of 
habitual smokers are rendered lazy and listless, indis- 
posed to bodily and incapable of much mental exertion. 
Others suffer from depression of the spirits, amounting 
to hypochondriasis, which smoking relieves for a time, 
though it aggravates the evil afterwards. Occasionally 
there is a general nervous excitability, which, though 
very much less in degree, partakes of the nature of the 
delirium trew.ens of drunkards.* I have known many 
individuals to suffer from severe nervous pains, some- 
times in one, sometimes in another part of the body. 
Almost the worst case of neuralgia that ever came 
under my observation, was that of a gentleman w r ho 
consulted the late Dr. Bright and myself. The pains 
were universal, and never absent ; but during the night 
they were especially intense, so as almost wholly to 
prevent sleep. Neither the patient himself nor his 
medical attendant had any doubts that the disease was 
to be attributed to his former habit of smoking, on the 
discontinuance of which he slowly and gradually re- 
covered. An eminent surgeon, who has a great 
experience in ophthalmic diseases, believes that in 

* Dr. Chapman and others have recorded cases simulating delirium 
tremens from the use of tobacco. ( Vide TJ. S. Dispensatory, and 
reports of insane asylums). The writer also hid an obscure case 
of insanity which nothing relieved until tobacco smoking was dis- 
covered as the cause, and discontinued, whei recovery speedily 
ensued. ( 



28 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

some instances he has been able to trace blindness 
from amaurosis to excess in tobacco, smoking; the 
connection of the two being pretty well established in 
one case by the fact that on the practice being left off, 
the sight of the patient was gradually recovered. It 
would be easy for me to refer to other symptoms indi- 
cating deficient power of the nervous system to which 
smokers are liable ; but it is unnecessary for me to do 
so ; and, indeed, there are some which I would rather 
leave them to imagine for themselves than undertake 
the description of them myself in writing. 

" But the ill effects of tobacco are not confined to 
the nervous system. In many instances there is a loss 
of the healthy appetite for food, the imperfect state of 
the digestion being soon rendered manifest by the loss 
of flesh and sallow countenauce. It is difficult to say 
what other diseases may not follow the imperfect 
assimilation of food continued during a long period of 
time. So many causes are in operation in the human 
body which may tend to a greater or less degree to the 
production of organic changes in it, that it is only in 
some instances we can venture to pronounce as to the 
precise manner in which a disease that proves mortal 
has originated. From cases, however, which have 
fallen under my own observation, and from a considera- 
tion of all the circumstances, I cannot entertain a doubt 
that, if we could obtain accurate statistics on the 
subject, we should find that the value of life in 
inveterate smokers is considerably below the average. 
Nor is this opinion in any degree contradicted by the 
fact that there are individuals who, in spite of the in- 
halation of tobacco smoke, live to be old, and without 
any material derangement of the health; analogous 
exceptions to tne general rule being met with in the 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 29 

case of those who indulged too freely in the use 
of spirituous and fermented liquors." 

Moreover, exceptional cases are also met with in 
those who use opium, arsenic and other poisons, and 
long-lived persons are met w T ith in malarious regions, 
but these anomalous instances do not prove that such 
noxious agents as alcohol, tobacco, opium, arsenic, 
malaria, etc., are conducive to health and longevity, 
when the general experience overwhelmingly pre- 
ponderates in demonstrating their potent deleterious 
and destructive properties, Besides, even if the lives 
of a comparatively few persons are prolonged in spite 
of the baneful effects of such pernicious influences as 
tobacco, alcohol, etc., it is only the lower vegetal and 
animal existence that persists, the higher intellectual 
and ps} 7 chical life being more or less deadened, so 
that the nobler faculties of the soul, that every one of 
any aspiration above the nature of the inferior 
creatures so earnestly desire, are debased and stifled, 
while the offending or exposed individual is pro- 
portionably reduced in the scale of being nearer to 
the plane of brutes rather than refined and developed 
toward the more exalted spiritual attributes of man- 
kind, to say nothing of the higher affinity with the 
Godhead. 

Respecting the evil effects of tobacco on the brain 
and nervous system more particularly, Dr. Willard 
Parker, of New York, states {Med. and Surg. Reporter), 
" This poison enfeebles the mind. The Emperor 
Napoleon had his attention called to this subject in 
1862 bv a scientific statistician. It was observed from 
1812 to 1862 that the tobacco tax averaged twenty- 
eight millions of francs annually and there were eight 
thousand paralytics and insane in the hospitals of 



30 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

France. In 1832 the tobacco revenue had reached 
one hundred and eighty millions, and, in the hospitals 
were forty-four thousand paralytics, etc. The un- 
doubted inference is that tobacco has a strong 
influence in producing these classes of nervous dis- 
eases. 

" A commission was then appointed to inquire into 
the influence of tobacco in the schools and colleges. 
After a full and careful investigation this commission 
reported that it had divided the people into two 
classes the users and non-users of tobacco, and then 
proceeded to compare them physically, intellectually 
and morally. The result was that those who do not 
use tobacco were stronger, better scholars and had a 
higher moral record. In consequence of this report 
an edict was issued prohibiting the use of tobacco in 
these national institutions, by which thirty thousand 
persons were at once forced to abandon it." 

But these observations take no cognizance of the 
many thousands of innocent persons of all ages and 
both sexes, from the newly-born babe to the most 
aged, degenerated, enfeebled, diseased and degraded — 
physically, mentally and morally, or destroyed en- 
tirely by the enforced inhalation of this potent poison, 
inflicted upon them by smoking barbarians, almost 
everywhere against every principle of sanitation, 
right and justice. 

On the " Influence of Tobacco in Diseases of Nerve 
Centres," Mr. Tamisier states in the Bulletin de V As- 
sociation Franc, cont VAbus du Tabac, quoted in the 
Doctor {Med. and Surg. Reporter), " That out of fifty- 
nine grave affections of the nerve centres observed 
from 1860 to 1869 among men, forty occurred in 
smokers. In fifteen cases of hemiplegia, nine abused 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 31 

tobacco and two used it moderately, four did not 
smoke. Of eighteen cases of paraplegia, five were 
great smokers, three moderate smokers, and ten ab- 
stained from tobacco. Out of sixteen cases of 
locomotor ataxia, ten were great smokers, five 
moderate and one abstained. Tamisier thinks that 
it is especially, if not wholly, to this cause that we 
must attribute the disease in the majority of cases of 
hemiplegia and of ataxia he has noticed since 1869. 
M. Lefevre, of Louvain, thinks it indubitable that 
excessive smoking causes paralytic mania; because, 
(1) nicotine causes in animals progressive enfeeble- 
ment of the muscles of motion up to paralysis and 
congestion of the nerve centres ; (2) analogous 
symptoms have been noticed in numbers of persons 
who abuse tobacco in smoking or chewing; (3) it 
has been found in all countries that there is a 
constant relation between the consumption of tobacco 
and the increase of general paralysis." 

" Effects of Alcohol and Tobacco on the Sight, on 
the subject of color blindness and amblyopia, Dr. 
Eichard H. Derby {New York Med. Journal)^ says, 
' Almost always both eyes are affected. This form of 
amblyopia occurs almost solely in men ; out of fifty- 
six cases only three were women. It is a disease of 
adults, its frequency increasing from the twentieth to 
the fortieth year. In a portion of the cases abuse of 
alcohol was certainly the cause of the affection and in 
others the excessive use of tobacco undoubtedly 
contributed to produce the disease. Forster, in a 
paper on the injurious action of tobacco on the vision 
attaches still greater importance to this agent as a 
cause of amblyopia, supporting the views of Macken- 
zie, Sichel, Hutchinson, Lureiro, and others. The 



32 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

author cites twenty cases in which there was a central 
scotoma with a horizontal diameter of 18° to 25°, 
within which large letters could still be recognized. 
All of these patients suffer from some affection of the 
digestive and nervous system. Loss of appetite, 
constipation, loss of sleep were common symptoms. 
Each one of the twenty patients was a strong smoker, 
and in eleven of these cases a very marked improve- 
ment was observed when the use of tobacco was given 
up." — [Detroit Review of Medicine and Pharmacy.) 

In some observations in the Anti-Tobacco Journal on 
the effects of this agent upon the animal economy, 
Dr. John C. Warren makes the following remarks in 
relation to its deleterious action on the tissues of the 
mouth : k< Tobacco is by some persons recommended 
as beneficial to the teeth, but while it can have no 
material effect in preserving the bony substance of the 
teeth it has a real influence on their vitality by 
impairing the healthy action of the gums. These and 
also the adjacent parts are very subject to cancer, 
particularly the tongue and lips. For more than 
thirty years I have been in the habit of inquiring of 
patients who came to me with cancers of these parts, 
whether they used tobacco, and if so, whether by 
chewing or smoking. If they have sometimes an- 
swered in the negative as to the first question I can 
truly say that to the best of my knowledge and belief 
such cases are exceptions to the general rule. When, 
as is usually the case, one side of the tongue is 
affected with ulcerated cancer, it arises from the 
habitual retention of the tobacco in contact with 
this part. The irritation from a cigar or even from a 
tobacco pipe frequently precedes cancer of the lip. 
The lower lip is more commonly affected by cancer 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 33 

than the upper in consequence of the irritation 
produced in this part by acrid substances from the 
mouth. What is more likely to cause a morbid 
irritation terminating in disease, than the frequent 
application of tobacco juice ? The want of attention 
to cleanliness often connected with this practice and 
the consequent lodgment of the particles of tobacco 
on the surface of the lip has a great influence in these 
cases. 

" Aged persons are very liable to cancer especially 
about the face, and when any irritating substance is 
applied habitually, the skin becomes disordered and 
takes on a cancerous action. This irritation may be 
produced by the use of tobacco in the interior of the 
mouth, by the habitual application of a cigar to the 
lips and even by a pipe applied to the same parts. 
Few days pass without my having an opportunity of 
witnessing the verification of these facts. " 

In relation to cancer in smokers the Med. arid Surg. 
Reporter states that " M. Bouisson, of Montpelier, 
has given another blast against tobacco in deducing 
the increased prevalence of labial cancer from its 
excessive and long-continued use. He relates sixty- 
eight cases affected with cancroid and cancerous 
tumors in persons addicted to smoking and thence 
traces a complete pathological history of the disease/' 
• ••*••• 

" There is no doubt says M. Bouisson, that cancer 
of the lip and other parts of the 1 mouth has become 
more frequent in proportion to the increased number 
of smokers and to the increased amount of smoking 
among those who had already contracted the habit 

the disease has progressed with the habit 

Besides the increased frequency of labial epithelioma, 



34 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

the author brings the following reasons to his aid, 
viz. : it attacks the lower lip mos,t frequently on 
which the pipe-stem or cigar habitually rests; it is 
rare among women and children. M. Bouisson 
speaks of a woman who was affected, but she was an 
inveterate smoker, and the older the smoker the 
more common is the disease, most of the cases being 
in men over forty years of age. Among the poorer 
classes who smoke short pipes and bad tobacco the 
disease is developed sooner than among the rich who 
smoke delicate cigars and long pipes and who 
neutralize the local effects of the combustion of the 
tobacco by hygienic means. The local action of the 
heat on the lips has probably some effect in the 
production of the disease, but tobacco alone would 
suffice. M. Bouisson gives the case of a physician of 
Barcelona, from whom he removed some epithelial 
vegetations in the nostrils, which he had no hesitation 
in ascribing to the practice so common among the 
Spaniards of eliminating the smoke of their cigarettes 
through the nose, and it is thus probably that in 
many cases epithelial cancers of the tongue, cheeks, 
arch of the palate, gums and tonsils are produced." 
Other surgeons testify to the same effect, Mr. Jona- 
than Hutchinson states [Med. Times and Gazette), that 
" Frorn the statistical analysis of 127 cases of 
epithelial cancer in the lip, I was able to show, first, 
that women are the subject of this disease in the 
proportion of only five to every one hundred males, 
second, that when it does occur in women it is usually 
in those who have been accustomed to smoke." 

In a recent discussion upon the subject of the use 
tobacco in the Suffolk District Med. Society, Mass. 
{Jour. Amer. Med. Assoc, Feb. 9, 1884), "Dr. H. I. 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 35 

Bowditch said that it is high time that some measures 
were adopted to stop, or at least restrain the use of 
tobacco. For thirty years he has continuously found 
a certain number of patients who have presented the 
symptoms of grave functional disturbance of the heart, 
for which no cause could be found except tobacco. 
There is no organic cardiac lesion, but it is a nervous 
weakness. This condition was very commonly 
observed during the late war. Nearly all the soldiers 
smoked and many gradually acquired what was 
appropriately named ' the tobacco heart.' 

" In habitues of tobacco we frequently find errors 
of digestion, sometimes of the most refractory char- 
acter, though many persons commence to smoke from 
the supposition that the digestion is benefitted by the 
use of tobacco. There is no question upon the fact 
that mental disease may be induced by the poisonous 
action of nicotine, and many smokers who are not 
insane have been rendered exceedingly nervous and 
irritable by the prolonged use of tobacco, and 
immediately give unmistakable evidence of absolute 
derangement if the customary indulgence is for any 
reason withdrawn." 

Yet they cannot recover unless they do discontinue 
the use of the poisonous drug, and the observation of 
the writer and others proves that it is essential to the 
restoration of health, which often promptly follows its 
disuse. 

Dr. Prince observed that " In cigarette smoking 
the vapor is inhaled and coming in contact with the 
delicate mucous membrane of the air passages, its 
active properties are at once absorbed and produce 
an immediate effect, which can be perceived to the 
tips of the fingers. The succeeding sensation is one 



36 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

of ennui, malaise, indolence, and muscular hebe- 
tude, which soon becomes burdensome unless the 
stimulant be renewed and prolonged by a fresh 
cigarette." This, however, necessarily only increases 
the evil, like drinking spirituous liquors to tem- 
porarily whip up the system from its resulting 
depression. 

" Dr. Langmaid stated that the most important 
questions in cigarette smoking are these : Does the 
inhalation of the vapor induce any disease of the 
mucous membrane with which it comes in contact? 
Does the smoke act upon the mucous, membrane 
simply as smoke or from the fact that it contains 
nicotine? Does smoking increase naso-pharyngeal 
catarrh? To these an affirmative reply must be 
given. If the mucous membrane is irritated, smoking 
invariably makes it worse. Will smoking produce a 
catarrhal state when none exists, or awaken a new one 
in a patient who has been cured of the disease ? 
Observation teaches that it can do this. There is an 
increased secretion from the membrane and all the 
other features of a catarrhal condition. Singers 
almost invariably abstain from smoking on those days 
upon which they expect to sing." 

" Dr. Bowditch added that he will not treat a 
patient for sore throat unless smoking is abandoned 
for the time." 

Thus, irritation, inflammation, ulceration of and 
defluxion from the mouth, throat, and air passages are 
excited by tobacco, with ammonsemia, superalkalinity 
and scorbutic condition of the system, which induces a 
malignant tendency to all diseases, local and general, 
and develops such diseases as diphtheria, cynanche 
maligna, typhoid fever, choleraic and other gastro- 
intestinal affections with cognate maladies, in both 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 37 

those who use and are exposed to this pernicious 
acro-narcotic poison. 

Besides, the local action of tobacco both upon the 
mucous membrane and skin is more immediately 
dangerous and may occasion speedy death, especially 
when applied to abraded or ulcerated surfaces, as 
exemplified in the following instance, with others on 
record. U A case of death from nicotine recently 
occurred at Cohoes, N. Y., under the following 
circumstances : The father of a little girl in an 
endeavor to ' heal a sore on her lip,' applied to it the 
contents of a ' rank' pipe-stem. The victim was 
almost immediately seized with the peculiar symp- 
toms of tobacco-poisoning and died a few hours 
afterward." — Med. Record. 

" Even the external application of the leaves or 
powder [of tobacco] is not without danger espe- 
cially when the cuticle is removed. A case of death 
is on record occurring in a child eight years old, in 
consequence of the application of the expressed juice 
of the leaves to the head for the cure of tinea capitis. 
Death has also been produced by the inhalation of the 
smoke." — U. S. Dispensatory. 

Before, however, there is one case of cancer or 
speedy death thus produced by tobacco, there are 
numerous instances of local irritation, inflammation 
and ulceration of the mouth, fauces, nares, and 
contiguous parts, with general poisoning of the blood 
and system by saturating the body with ammonia, 
nicotia and its other noxious ingredients, thereby 
preventing oxidation of the fluids and solids of the 
economy, causing anaematosis, dyspepsia, mal-nutri- 
tion, diseases of the throat, air passages, lungs, heart, 
stomach, liver, kidneys, brain, nervous, muscular and 



38 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

general system, in fact, deterioration, depression and 
disease of both body and mind ; often ending in 
inanition, consumption, insanity, paralysis and death, 
not the less sure because it is so generally insidious 
and slow, though frequently directly well-marked and 
prompt in its poisonous action, corroborative evidence 
of which might be adduced sufficient to fill a volume in 
proof of the local and general poisonous influence of 
tobacco upon the vital organism, but it is believed the 
preceding will amply suffice for the special designs of 
this work, though the following instructive case may 
serve to further demonstrate the potent toxic power 
of this noxious drug. 

A striking example of the certainty and rapidity 
with which a superalkaline, scorbutic, and poisoned 
condition of the blood, with oppression of breathing, 
depression of the heart, nervous and general system, 
may be produced by even a slight exposure to the 
noxious fumes of tobacco is presented in the case of a 
gentleman under my care, who is a martyr to its 
baneful effects and has suffered untold misery there- 
from. Thus, a very moderate inhalation of the fumes 
of tobacco emanating from the body and clothes of a 
smoker, and so much the more from the smoke itself, 
always causes a sw r ooning sensation (even before he 
smells it or is otherwise aware of its presence), with 
headache, neuralgia of the maxillary and facial nerves, 
neuralgia, spasm, and soreness of his heart, feeble, 
intermitting pulse, shortness of breath, huskiness of 
voice, sickness of stomach, torpor of liver, cholaemia, 
and such a deterioration of his blood as to induce 
swelling and soreness of his gums, with sometimes 
bleeding therefrom, looseness of his teeth, alveolar 
abscess, suppression and disorder of the functions of 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 39 

the chylopoietic viscera, and general prostration, with 
even an occasional attack of cholera morbus. Some 
years since a slight exposure to the fumes of tobacco 
(wilfully inflicted upon him, as he verily believes, by 
one who knew his infirmity), laid him up in bed for 
ten days with congestion of, and haemorrhage from 
his lungs, and invalided him for a long time there- 
after. In fact, he is so susceptible to the poisonous 
effects of tobacco, directly upon his blood, heart, and 
nervous system, as to seriously endanger his life and 
induce a state of enforced invalidism from occasional 
accidental exposures thereto, so that he is obliged to 
carefully avoid it, and every one that uses it, hence to 
live a very retired life to be free therefrom ; during 
which his health is generally good though not vigor- 
ous, except a persistent tendency to alveolar abscess, 
and laryngeal irritation with tubercular sputum there- 
from that sinks at once in water, and weakness of 
voice, which get better or worse with the varying 
states of the S3 7 stem, according to freedom from, or 
exposure to the pernicious action of the tobacco 
miasm, as in his efforts to maintain himself he is com- 
pelled to go about more or less, although at much risk, 
having thus to struggle against a state of enforced 
invalidism, seclusion, and privation, inflicted upon him 
by this smoking barbarism of the age from those thus 
engaged in artificially generating and diffusing this 
potent pestiferous tobacco miasma, which he is power- 
less to resist even in a moderate degree, and unable to 
altogether avoid by an isolated life, so that after 
enduring untold torture of body and mind therefrom, 
he will doubtless fall a sacrifice to this baneful poison 
and barbarous custom of tobocco smoking. 



40 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

This, of course, is an extreme case, but with other 
evidence, it strongly illustrates the pernicious power 
of tobacco to induce a superalkaline, scorbutic, and 
toxic condition of the blood, arrest oxygenation and 
circulation, subvert nutrition and secretion, and pro- 
duce depression of the nervous, muscular, and general 
system, directly dangerous to life, as well as promotive 
of congestive, hsemorrhagic, toxemic, necraemic, scor- 
butic, zymotic, septic, mephitic, lithsemic, ■ and ady- 
namic diseases, with local disorders of the nares, 
mouth, throat, air-passages, lungs, heart, stomach, 
liver, bowels, brain, kidneys, and other organs, accord- 
ing to special tendencies and circumstances, or a toxic 
state of nicotism, analagous to narcotism and alcohol- 
ism. This potent tobacco poison thus strikes at the 
very basis of life — the blood, heart and circulation, 
with the nervous and nutritive systems, and kills 
many who are thought to die with other forms of 
toxaemia, paralysis of the heart, brain, and nervous 
system, or affection of the lungs, kidneys, with other 
diseases, when the real cause is nicotism of the blood, 
heart, lungs, kidneys, brain, nervous, and general 
system, especially in weakly and sensitive men, women, 
and children, who are largely afflicted and sacrificed 
thereby. Nor is this singular in view of the peculiar 
constitution of tobacco, it being a congeries of some 
of the most powerful alkalies and poisons known, the 
principal of which are ammonia, with nicotia, nico- 
tianin, colludine, the pycoline bases, and other noxious 
agents, nicotia alone being a potent alkali, emetic, 
cathartic, narcotic and sedative, ranking next to prussic 
acid, which itself is said to be a constituent of tobacco 
smoke by eminent authorities. [Vide National, U. S. 9 
and other Dispensatories.) 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 41 

Thus, this aramonsemia and superalkalinity of the 
blood and body from whatever cause, whether from 
intrinsic systemic or extraneous sources, or both com- 
bined, has a direct basic influence in the production of 
a great variety of constitutional and local diseases, of 
a more or less grave and pestilential nature according 
to special morbific circumstances of alimentation, 
climate, meteorological, malarial, and other pathogenic 
conditions, occupations, habits and modes of living, 
such as scurvy, purpura, congestive, typhus, typhoid, 
yellow, bilious, remittent, puerperal, and other low 
fevers, with small-pox, cerebro-spinal meningitis, scar- 
latina, measles, cynanche maligna, diphtheria, erysipe- 
las, eczematous, with carbunculoid affections, cholera, 
and correlative zymotic, septic, mephitic, infectious, 
scorbutic, adynamic, and colliquative maladies, some of 
which may be excited, and all intensified, by exposure 
to the pestiferous miasm of tobacco smoke, with other 
ammoniacal, or alkaline, sedative, and noxious agents. 

Besides its general influence to produce an ammoni- 
cal or superalkaline, poisoned, and scorbutic condition 
of the blood, with disorder of the circulation, and 
depression of the nervous and general vital energies, 
tobacco also exerts a special ^etiological power to 
excite disease of the nares, mouth, throat, air-passages, 
lungs, heart, stomach, liver, bowels, kidneys, brain, 
and other organs, even in adults, and so much the 
more in children who are so susceptible thereto and 
freely exposed to its noxious influence everywhere. 
Hence, as this tobacco miasm produces similar patho- 
logical conditions both local and constitutional, it is 
more than probable that it is a prolific exciting as well 
as predisposing cause of that generally prevalent and 
fearfully destructive disease — diphtheria, and actively 



42 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

increases its inception, intensity, and fatality, with 
that of all other correlative zymotic, septic, and ady- 
namic maladies previously indicated. Smokers are 
thus actively engaged in poisoning, degenerating, 
diseasing, and destroying themselves, children, and 
others (of all ages and both sexes), by engendering 
and diffusing everywhere, this pestiferous tobacco 
miasm, that all exposed thereto must inhale and poison 
their blood and bodies therewith nolens volens, the per- 
nicious effects of which are usually attributed to some 
occult infection, microzyme, or other obscure cause, 
when they are really entirely due to this baneful 
tobacco malaria, independent of, though often compli- 
cated with, other morbific and specific pestilential 
agents. 

In the pathology of diphtheria there are three promi- 
nent lesions, viz. : (a) of the blood and circulation, 
of a superalkaline, scorbutic, and toxical nature ; 
(6) of the throat, with congestion and inflammation, 
ulceration and plastic exudation, though this latter 
may also occur in other parts of the body; and, (c) 
of the nervous centres more directly connected with 
the pharynx, as well as of the system in general of an 
adynamic type; all of which are thus of an asthenic 
character. But while in the lesion of the throat, the 
most marked characteristic of the disease is of an in- 
flammatory nature, it is of a low grade and more 
analogous to erysipelatous and gangrenous, than 
ordinary croupous inflammation, though closely allied 
therewith, the membranous exudate being alike fibrous 
in both. Yet, in general, croup and diphtheria differ 
widely in both their pathology and treatment, the 
former being of a more purely local sthenic inflamma- 
tion, with fibro-plastic exudation independent of a 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 43 

primary scorbutic and toxemic complication and sys- 
temic debility, while the latter is of an asthenic in- 
flammatory character dependent upon, or complicated 
with, ammonaemia, septicaemia, and general adynamia. 

These diseases, however, correlate and merge in 
every degree with each other, like all other inflamma- 
tory and septic disorders, though the extremes are 
well markefl, and which give rise to such endless con- 
fusion both in pathology and therapeutics. 

In diphtheria the basic lesion is in the blood, that 
vital fluid becoming deteriorated, scorbutic, toxemic, 
septic, and infectious, from apparently an excess of the 
organic alkali — Ammonia, engendered within, or in- 
troduced from without the body, or both together with 
other deleterious agents. This ammoniacal state of 
the blood, or ammonaemia, induces a toxical, solvent, 
and inflammatory condition thereof, with disposition 
to congestions, defluxions, and plastic exudations, with 
purulent and gangrenous affections and low forms of 
disease, from local irritation of any kind, often more 
particularly in the liver, lungs, air-passages, and 
pharynx, perhaps from their supersusceptibility to 
extraneous with intrinsic exciting causes of disease, of 
which the irritant, depressing, alkaline, and toxic 
fumes or smoke of tobacco are an active exciting, as 
well as predisposing, cause thereof, though the same 
agencies and dyscrasia will operate to produce a variety 
of asthenic diseases — local and constitutional, accord- 
ing to special tendencies, and complications, specific 
infections, climatic, malarial, meteorological, and other 
influences. 

Thus, this one pernicious miasm of tobacco alone, 
supplies all the active aetiblogical and morbific factors 
to engender diphtheria, with correlative affections, as 



44 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

by its ammonia and nicotia, it induces superalkalinity 
of the blood, and still more general toxaemia from these 
and its other noxious constituents, besides those cor- 
rupt products secondarily developed and retained in 
the blood and body from its baneful action thereon, 
while it directly irritates the throat and air-passages, 
and excites congestion, inflammation, and ulceration 
therein, powerfully depresses the nervous and vital 
energies, and paralyzes the heart, brain, nervous, 
.muscular, and general system, even of adults, and so 
much the more of children, who are so susceptible to 
this pestiferous poison and disease. Moreover, w 7 hen 
to this is superadded other potent morbific factors, as 
various forms of malaria, cold and moisture, undue 
exposure to bad weather, confined and impure air, 
draughts, and other causes of ammonsemia, septi- 
caemia, and catarrh, with defective dietary, and bad 
modes of living, it is not wonderful that diphtheria 
is so frequent and fatal, but that it should not be more 
prevalent and deadly. 

The origin of this frequent and fatal disease — diph- 
theria, with all allied maladies, is, I believe, of a more 
purely chemical or chemico-organic character, inherent 
in the system, rather than dependent upon extraneous 
organic entities, especially of the now fashionable 
microzymes, the presence of these being secondary and 
subordinate, rather than primary and supreme factors 
of this, with other diseases, now so exclusively at- 
tributed thereto. The germ theory is defective in 
that it assumes sequents for antecedents, effects for 
causes, and disregards too much the inherent chemico- 
organic and bio-dynamic basis of disease as well as 
health, disease and death with life and health being 
inherent in the vital organism, independent of 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 45 

extraneous agencies, though necessarily correlated 
therewith, especially those chemical and dynamical 
influences comprised in food and air, heat, light, 
electricity, etc., essential for organization and life 
action. If the germ theory was so generally true 
where did the primordial germ receive its morbific 
germ from to excite disease ab initio ? While there 
may be parasites ad infinitum, there must necessarily 
have been none such with the primeval organism 
which started anew from its constituent chemical 
elements, the abnormal variations or aberrations of 
which with their affinitive forces created abnormal 
conditions, or disease. It is, therefore, apparent that 
these accredited pathogenic micro-organisms cannot 
always or even so frequently as usually thought, be 
the primary ^etiological factors of disease, but rather 
secondary and sequential products or concomitants 
and complications thereof, the ammoniacal, scorbutic, 
septic, and necrsemic conditions of the blood and 
components, or humors and tissues of the diseased 
economy affording an appropriate nidus for their 
development, existence, and activity, organic decom- 
position everywhere being a prolific source and 
support of microzymes and the lower organisms. 

Diphtheria, in my opinion, is frequently of spon- 
taneous origin from morbid systemic and local chemico- 
organic and dynamic action, as well as often developed 
and intensified by extraneous chemico-toxic and 
alkaline agents like tobacco, ammonia, sewer gas, 
foul air, meteorological, and other inorganic agencies, 
independent of micro-organisms or infection, though 
like erysipelas, capable of transmission after its 
spontaneous as well as secondary inception, when 
there are favorable conditions for its communication, 



46 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

as a specific contagium is engendered in both 
instances. The same rule applies, I believe, with all 
the zymotic, septic, contagious and infectious diseases, 
which may originate spontaneously and engender a 
specific virus in each instance, that will extend their 
special maladies indefinitely unless counteracted by 
some suppressing power, the intensity thereof being 
proportionate to the basic superalkalinity of system. 
This spontaneous development of specific disease and 
contagium is clearly manifested in grease, glanders, 
hydrophobia, gonorrhoea, erysipelas, puerperal, and 
typhus fevers, with, in my opinion, all other correla- 
tive maladies from the least to the most contagious, 
which though usually transmitted, often also originate 
denovo, like fire in spontaneous or artificially developed 
combustion, and secondarily communicated whenever 
the essential factors of either are brought together by 
accident or design. In fact, in accord with the 
general laws of nature, it is most probable that all 
diseases — from the most benign to the most malignant 
and contagious, originate spontaneously, as all the 
former, and some of the latter, are known to do, 
whenever concurring circumstances are favorable, 
which it is the object of science to discover and 
counteract in all cases alike. 

That there is thus some insidious potent and gene- 
ral cause of diphtheria with allied septic, contagious, 
and adynamic affections, independent of the usual 
extraneous morbific agencies, is manifest from their 
frequent spontaneous development where there is 
comparative freedom from the ordinary most active 
pathogenic influences both contagious and innocuous, 
even where the sanitation seems to be so perfect as to 
avert or counteract the tendency to the milder 



DIPHTHERIA, TYPHOID, AMD ALLIED DISEASES. 47 

abnormities much less to permit the origin of any 
malignant disease. In relation to this subject, with 
regard to a recent epidemic of diphtheria in Mansfield, 
Ohio, Dr. Mary J. Finley thus concludes {Cincinnati 
Lancet and Clinic), " A careful study of a number of 
reports of diphtheria in different parts of the United 
States and in other countries, has convinced me that 
epidemic diphtheria occurs with almost equal malig- 
nancy under the best and the worst sanitary condi- 
tions. The most desirable hygienic surroundings, 
and the most irreproachable water supply, afford no 
security against its attack." 

Yet, while there may be almost perfect sanitary 
precautions and conditions in other respects, there is 
one potent miasm and morbific factor of diphtheria 
with allied diseases artificially engendered and diffused 
almost everywhere throughout the world from the 
hovel to the palace among all classes and conditions 
of people, from the lowest to the highest, in the 
omnipresent and pestiferous tobacco smoke that 
penetrates and pollutes the lungs, blood, and bodies 
of all exposed to its pernicious influence, alkalizing 
and poisoning the fluids and solids of the body, 
depressing the nervous and vital energies, irritating 
the throat, air-passages and lungs, and specially pre- 
disposing to, and exciting adynamic and malignant 
diseases, both local and constitutional, and directly 
and indirectly of the pharynx as well as other parts of 
the system. Hence, in view of the almost universal 
presence and powerful morbific influence of this 
potent alkaline and acro-narcotic tobacco miasm, it is 
not at all surprising that diphtheria and its pestiferous 
analogues arise and spread spontaneously so frequently, 
generally, and fatally. It does not follow that because 



48 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

this powerful acro-narcotic is unsuspected or disre- 
garded that it is less actively poisonous and destruc- 
tive, any more than the unrecognized presence of 
carbonic acid would diminish its baneful and deadly 
effects. 

Dr. Willard Parker, of New York, says (Medical 
and Surgical Reporter), " That tobacco is a poison, 
is proved beyond question. It is now many years 
since my attention was called to the insidious but 
positively destructive effects of tobacco on the human 
system. I have seen a great deal of its influence 
upon those who used it, and worked on it, or in it. 
Cigar makers, snuff manufacturers, etc., have come 
under my care in hospitals and private practice ; and 
such persons never recover soon and in a healthy 
manner, from any case of injury or fever. They are 
more apt to die in epidemics, and more prone to 
apoplexy and paralysis, the same is true, also, of all 
who chew or smoke much." And, it might have been 
truthfully added, likewise of those who are exposed to 
the baneful influence of this pernicious poison in any 
manner or form. 

" M. Mercier in corroboration of the unsuspected 
effects of tobacco in generating disease, related a case 
in which a cough, which had persisted for a year, 
and purpura, which had lasted for seven months, soon 
yielded after the cessation of smoking, which had 
been excessive. His own practice had furnished him 
full proof of the depressing effect of this agent upon 
the generative functions."* — U Union Med. and British 
and For. Med. Chir. Rev. 

* In moderate quantities, however, tobacco excites the sexual 
passions, and stimulates to vice and immorality. 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 49 

But cases are frequently presented of affections of 
the mouth, throat, nares, air-passages, pulmonary, and 
other organs, blood, nervous and general system, 
usually attributed to various other causes, that are 
really directly produced by this potent tobacco poison, 
as demonstrated by the marked improvement and 
rapid recovery when relieved therefrom. 

The following observations of repeated outbreaks of 
diphtheria in isolated places far away from contagious 
influences and previous existence of the disease, 
strongly support this view of its frequent development 
de novo, when concurrent conditions are favorable to 
its occurrence. 

Dr. T. J. Hutton, of Minnesota, states in the Medical 
Record, quoted by the Scientific American that within the 
past three years he has treated sixty-four cases of diph- 
theria. " These cases were all in comparatively new 
houses, iu a belt of country where white men never 
lived before, so that the soil contained no sewage, 
and had no accumulation of surface filth. Diphtheria 
had never before been there, and could not have been 
brought by visitors ; it was of a malignant type, and 
some families lost five and six members each. All of 
these cases were included in seventeen rural out- 
breaks, three of which were in summer, and seventeen 
in winter, and every house attacked was small and 
greatly overcrowded. Many of the winter outbreaks 
happened when the temperature was 30° to 40° F. 
below zero, which w r ould have- been death to all 
ordinary surface germs, and in one instance the 
thermometer registered 60° below, when the surface 
of the earth and all bodies of water were frozen 
solid." In the absence of most of the usually at- 
tributed causes thereof, Dr. Hutton infers that 



50 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

" diphtheria is caused by ochlesis or crowd poison," 
and " may occur sporadically, any small overcrowded, 
ill ventilated house may prove a diphtheria factory/' 
That temperature directly has none, but indirectly 
much to do with it, as overcrowding with confined air 
is most apt to occur in cold weather, hence " an 
abundance of pure air is the first requisite in treat- 
ment. I have seen patients apparently moribund, 
restored by fresh air and food alone. So have other 
observers." 

But this so-called " crow T d poison" is largely com- 
posed of the ammoniacal and organic excreta from 
the lungs, blood, and bodies of many human beings 
confined in a limited space. While in the cases cited 
they were doubtless augmented and intensified by the 
additional baneful miasm of tobacco smoke, with its 
noxious component ammonia, nicotia, and other 
poisons, which are generally so freely and recklessly 
engendered and diffused everywhere to the injury of 
sensitive and sickly men, women, and children 
especially, thus acting both as predisposing and excit- 
ing causes of diphtheria and allied throat, with other 
asthenic diseases — local and constitutional — in persons 
of all ages, young and old, weak or strong, who are 
incapable of resisting the potent morbific influence of 
any one of these baleful poisons, much less the 
compound and combined power of all these active 
materies morbi and causes of disease, concentrated, 
particularly in crowded and close places, where 
tobacco smoke with other forms of malaria are usuallv 
so common. 

Further evidence of the spontaneous origin of 
diphtheria is afforded by the observations, experience, 
and experiments of various scientists, notably recently 



DIPHTHERIA, TYPHOID, AXD ALLIED DISEASES. 51 

of Drs. Wood and Formad, thus presented in the 
Philadelphia Ledger^ among the views of prominent 
physicians of that city, upon the subject, collected by 
visiting reporters thereto. 

"Dr. Horatio C. Wood, of the Faculty of the Uni- 
versity of Pennsylvania, and one of the Philadelphia 
cientists who has made a special study of diphtheria, 
was also visited and cheerfully furnished the following 
facts relative to the subject. Several years ago Dr. 
Wood and Dr. Henry F. Formad, under the auspices 
of the National Board of Health, entered upon an 

aborate investigation into the nature of diphtheria, 
and in his conversation with the Public Ledger repre- 
sentative he frequently referred to the points pre- 
sented as having been the results of the joint labors. 

M< We find that there is always present in the mem- 
wanes a small microscopic plant, and that in some 
cases of the disease, with violent fever and other 
general disturbances, this plant forces its way through 
the lymphatic vessels of the neck into the blood 
vessels and attacks certain parts of the blood, grows 
in the kidneys, marrow of the bones and in some 
other of the internal organs. We succeeded in pro- 
ducing diphtheria in the lower animals with mem- 
branes from the throats of children who had been 
afflicted; then rubbing up the membranes with water 
and filtering out all solids, found that the w r ater was 
not capable of producing the disease in animals, but 
that the solid particles left after the filtration con- 
tained the poison. It was also found that the plants 
escaped in an isolated condition with the urine from 
the kidneys, and that thus isolated it acts as a deadly 
poison, producing diphtheria in the lower animals. 
We also succeeded in cultivating the plant entirely 



52 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

away from any animal body, and, by the third or 
fourth generation of the plant, produced diphtheria 
in the lower animals. The disease as it was produced 
in the lower animals resembles exactly the disease in 
man. It is contagious, produces membrane, and the 
animal dies with symptoms similar to those of a sick 
child. 

" ' The various veterinary surgeons/ continued Dr. 
Wood, ' have from time to time asserted that it occurs 
spontaneously in animals, and that it may be passed 
from the lower animals to man. Dr. Forraad once 
observed such an epidemic among rabbtis, and a 
number have occurred in which dove-cotes in Bel- 
gium have been visited and the birds destroyed by 
the disease. I have known cases in which there 
was reason to believe that children contracted 
diphtheria from handling cats which suffered from 
the disease in a mild form. 

" ' A very careful study of an epidemic among calves 
was made by the head of a Hanoverean College of 
Veterinary Surgery. The calves were believed to 
have contracted the disease from a child of the hostler 
of the inn who died from it. The disease attracted 
so much attention that a professor was sent for, he 
found a large number of calves sick, proved that the 
disease was contagious, and advised the veterinary 
surgeon in charge to apply remedies to the throats of 
the calves as in cases of human diphtheria. In four 
or five days the local veterinary surgeon was seized 
with diphtheria, and suffered from a violent attack. 
The person who followed him in applying the 
remedies to the calves was similarly affected, but the 
attack was less virulent. 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 53 

" ' It seems, therefore, well established that it is 
Dossible for diphtheria not only to pass from men to 
animals, but from animals to men. A curious in- 
stance of such passage was met with by Dr. Formad 
ind myself, during our researches. In the woods of 
Michigan an isolated household was attacked, and the 
slops from the sick room was thrown into the pig-sty 
and devoured by one of the pigs. This pig sickened 
and died. At the autopsy the stomach was found to be 
covered with a dense diphtheritic membrane, which 
was fall of the plant peculiar to the disease. The 
blood, kidneys and other vital organs were also full, 
precisely as in the cases. of children who have died in 
malignant diphtheria. This case is important as 
being in accord with experiments which show that 
the plant has little tendency to enter the blood 
primarily, but finds its first lodgment in the throat 
or some other part, and afterwards enters the blood 
through the ulceration of the part. 

"' Diphtheria is, therefore, in the majority of cases,' 
Dr. Wood went on to say, 'primarily a local disease, 
and is to be arrested by local treatment. Another 
important fact which we have arrived at was that the 
plant of diphtheria is not different in kind from a 
plant which is always present in the mouth of 
healthy people, but that, under certain conditions, 
this ordinarily harmless plant begins to grow 
with great rapidity. In its ordinary condition 
it has little tendency to grow, and is not noxious, 
because it is inert. During its active stage it is 
injurious, because it continually tends to develop 
itself at the expense of the animal in which it is. 
It is evident that the condition which favors the 
passage of the plant from the inert to the active 



54 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

condition may exist inside the body of a person, or 
may exist on the outside of him. In our studies it has 
become very apparent that such towns as Williamsport 
and similar centres in lumber districts are especially 
proven to suffer from extraordinarily violent epidemics 
of diphtheria, and this seems to depend upon the 
presence of great masses of sawdust. In Michigan, 
a large town in the winter of 1880-81 was visited by 
an epidemic which was confined to those wards that 
were built upon a ground made by filling up a swamp 
by sawdust. The public schools were broken up, 
but one-eighth of the children were said to have died. 
In such localities, I believe,, with Dr. Formad, that 
the conditions favorable to the growth of the plant 
exist outside of the human system. It passes from 
the inert to the active condition, so that the air 
becomes full of the poison and an epidemic results. 
On the other hand, a weak, sickly child gets a cold 
and a sore throat. The plant in its mouth, in an 
inert condition, finds exudation and tissues of low 
vitalitv, excessive warmth and all the conditions 
stimulating it into activity. The plant thus favored 
passes from an inert into an active condition, and the 
result is that a simple sore throat is converted into 
diphtheria. In the first case mentioned an epidemic 
has arisen ; in the second, a self-generated diphtheria. 
The plant, which has in the mouth of the child passed 
from the inert to the active condition, escaping from 
the mouth is ready to grow and produce diphtheria 
in the throat of the second child; so that the diph- 
theria which has originated spontaneously is con- 
tagious and may finally give rise to an epidemic. 

"' The plant does not differ from a similar organism 
found in putrid wounds. If it alights upon a sore 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 55 

nger or any wound it produces disease at that point. 

Many physicians and nurses have lost their lives by 

loughing wounds produced in this way. We believe, 

herefore,' continued Dr. Wood, speaking for himself 

ind Dr. Formad, 'that diphtheria is nothing more or 

ess than that which was called forty years ago, 

putrid sore throat." 

ui The fact that the plant escapes from the kidneys 

n so active and virulent a condition and in such 

nasses shows the importance of disinfecting the 

lischarges at once in all cases. The vessels should 

iave the disinfecting material placed in them before 

ise, so that if possible the plant should be killed 

mmediately. The researches at the University of 

Pennsylvania .-how that while carbolic acid, arsenic 

md many other substances have the power of killing, 

here is no ordinary agent equal to corrosive sub- 

imate. It should be borne in mind that carbolic 

\cid is not less poisonous than corrosive sublimate; 

t has taken life in 1?> minutes. Corrosive sublimate, 

n proportion to its power over the organism, is less 

dangerous than carbolic acid, and probably a solution of 

the former, to which some mal-odorous substance is 

added to prevent its being taken by mistake, would be 

^ safer and more efficient disinfectant than carbolic 

icid. 

11 'What has been said shows the supreme importance 
}f very careful attention to all cases of sore throat in 
3hildren, especially weakly childreh. The child is only 
more apt to suffer from diphtheria than the adult 
because the membrane of the throat is more tender, 
nore readily becomes inflamed, and is more easily 
penetrated. The great check to the growth of the 
liphtheria organism is always the vital power of the 



56 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

tissues opposing it. A weakly child has lower re- 
sistive power in its tissues; owing to such low resistive 
power a sore throat in a child of that character is 
very prone to become diphtheritic. The second point 
alluded to is the great importance of local treatment 
of the throat. This should have two objects: First, 
to subdue the inflammation and check the sore throat, 
and second, to kill the plant. The general treatment 
of children should have for its object the destruction 
of the plant within the body, but no agent is known 
which is poisonous to the plant which is not also 
poisonous to the child, and therefore it can do little 
good to kill the plant if at the same time the patient 
is destroyed. All that can be done is to sustain the 
child, as to increasing its resistive power. It is a 
battle between the life of the child and the life of the 
organism. Unfortunately we cannot take life from 
the organism, but we may add life, force, or vitality 
to the child, and in some cases this addition may be 
sufficient to decide the fate of the conflict in favor of 
the child. 

"'The relations of diphtheria to scarlet fever/ con- 
tinued Dr. Wood, ' also have great light thrown on 
them by the results obtained at the University. The 
membrane in the throat of a scarlet fever patient 
contained myriads of plants — micrococci — precisely 
like those of diphtheria, and in the blood of some 
cases of scarlet fever there is finally an abund- 
ance of these plants, which are also to be found 
in the kidneys and other organs. In malignant 
measles the same plant is found in the throat and in 
the blood finally. It is plain that this plant, always 
being in the mouth, is ready always to pass from the 
inert to the active condition. A child gets scarlet 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 57 

fever and an inflammation of the throat follows. The 
diphtheritic plant begins to grow, and it may be that 
finally it becomes very active, produces a diphtheritic 
disease, enters the blood and kills the child. The 
child may have escaped the first evil effects of scarlet 
fever poisoning to die of diphtheria, which is second- 
ary to the scarlet fever, an indirect effect of scarlet 
fever poison. "We believe that in many acute diseases 
the cause of death is this secondary septic poison. A 
curious element of prognosis has been made out in 
the course of our study as important in all the dis- 
eases. So long as the white corpuscles of the blood 
are not attacked by the organism, the chances are 
favorable to the patient, but whenever the microscopic 
examination shows the presence of the organisms in 
the white corpuscles the chances are greatly against 
the patient, however unimportant other symptoms 
may seem.'" 

" Dr. Henry F. Formad, of the University of Penn- 
sylvania, expressed himself against the prevailing 
view that diphtheria is a direct contagious disease, 
although he admitted that clinical evidence often 
indicated a diphtheritic contagion. He had repeatedly 
observed spontaneous diphtheria in animals and in 
many instances in man. Experimental evidence was 
also not in favor of the contagiousness of diphtheria. 
From his observations he rather believed that similar 
exposure, habits, surroundings and conditions of life, 
and not the actual transmission of a poison, were the 
agencies at work through which a number of indi- 
viduals in one house, or of one street, or a whole 
community, become attacked by diphtheria. 

"From his experiments, in conjunction with Prof. 
H. C. Wood, under the auspices of the National 

D 



58 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

Board of Health, he had come to the conclusion that 
every case of diphtheria was a primary origin and a 
local disease, and only secondarily becoming consti- 
tutional. He believed that diphtheria was merely a 
putrid sore throat, either without or with secondary 
blood-poisoning, and only in the latter case leading 
to a fatal termination. Death, however, also may 
ensue from suffocation, this being occasionally brought 
on through the mechanical blocking up by false 
membranes of the windpipe. The secondary blood- 
poisoning in diphtheria he considered to be due to 
the introduction of minute round fungi (micrococci) 
into the blood. 

" These micrococci exist in countless numbers upon 
the mucous membrane of every healthy individual, 
but they acquire a morbid life activity if bred in the 
purulent exudate of an intensely inflamed throat, and 
gain easily entrance to the system by means of the 
blood-vessels and lymphatics, which are torn open in 
the local sloughing ulceration. Diphtheritic inflam- 
mation and exudates occurs in various parts of the 
body, and may complicate any ulcerating wound 
without doing any harm if attended to well, locally. 
On the other hand, any intense simple inflammation 
in the throat (particularly that of tender children), 
with its numerous lymph-glands, blood-vessels and 
absorbing channels, may lead to the formation of a 
false membrane, and finally to that fatal constitutional 
malady called diphtheria. When occurring in the 
windpipe it is designated as croup, and it is here that 
death from suffocation is common usually long before 
any constitutional symptoms from blood-poisoning 
can develop. Pathologically, croup and diphtheria 
are identical ; clinically they differ ; on account of the 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 59 

anatomical peculiarities of the parts affected the 
symptoms and terminations are of necessity at vari- 
ance. Concerning treatment Dr. Formad did not 
express any opinion, leaving this to practicing physi- 
cians. Moreover a variance treatment may be indi- 
cated in each individual case. He considered, 
however, local treatment of supreme importance; 
the object of local cauterization being to transform a 
putrid sloughing surface into a healthy granulating 
one, which, under proper hygienic measures could 
heal. Such means judiciously applied can, if success- 
ful, prevent the absorption of septic matters into the 
system." 

Furthermore, it is stated in the Journal of the Ameri- 
can Medical Association, that, according to the remarks 
of Dr. H. C. Wood, at the recent meeting of the 
Pennsylvania State Medical Society, in relation to 
diphtheria and micrococci, besides this microphyte 
" in the ordinary natural saliva of every person's 
mouth that cannot be distinguished from the micro- 
coccus of the most malignant diphtheria," being 
" as far as could be discovered identical. The 
same micrococci were found in great abundance 
in cases of puerperal metritis, sloughing sores, and 
gangrenous wounds, from which he infers that 
diphtheria is not a specific disease, but simply a 
putrid or septic sore throat, of greater or less severity 
in different cases. This is returning very nearly to 
the opinions derived from clinical observation fifty 
years since." 

It is thus seen that the same microbes exist in both 
health and disease of various kinds, and their 
relative degree of development, activity, and innocu. 
ousness or malignancy depend upon the character of 



60 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

the soil most favorable for their evolution and energy, 
both within and without the living organism. Now, 
as ammonia is constantly engendered more or less 
freely in the earth, air, and vital economy, and is the 
common basic food of plants from the smallest to the 
largest, while it is both frequently produced and 
introduced in excess within the living system, it is 
most probable that the development, activity, and 
malignancy of these parasitic microphytes depend 
upon the ammoniacal condition of the fluids and 
solids of the body, which thus affords within itself the 
basic pabulum, materies morbi, predisposing and 
exciting causes of all such malignant microzoa and 
diseases, as manifested in diphtheria, angina maligna, 
scarlatina, typhoid, ship, yellow, enteric, puerperal, 
and other septic fevers, with small-pox, erysipelas, 
cholera, and correlative maladies, as well as the more 
contagious and mephitic types and complications of 
all other diseases — local and general, many of which 
are ordinarily of a mild, incorrupt, and non-infectious 
character, but become putrescent, malignant, and 
contagious, whenever this ammonsemia and super- 
alkalinity of system results. 

Thus, there is identity of cause with multiple 
diseases, or autogenesis of both materies morbi and 
morbidity, with autosepsis, autoinfection, adynamia, 
malignancy, zymosis, and contagion, variously mani- 
fested and complicated. 

This ammoniacal state of the fluids and solids of the 
vital economy is thus doubtless, in fact, the basis and 
underlying complication of every form, variety, and 
grade of disease — functional and organic, acute and 
chronic, local and general, of a scorbutic, necrsemic, 
septic, zymotic, contagious, mephitic, and putrescent 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 61 

type, as it supplies the essential pabulum for the 
development of microzymes, toxic, and contagious 
principles, the degree of activity and malignancy 
being proportioned to its preponderance, and pro- 
duction, or retention, and introduction into the 
system, while the special variety, specific contagia, 
and manifestations, depend upon secondary and 
extraneous conditions of a chemical, mechanical, 
dynamical, and organic character, intrinsic in, or 
extrinsic to the vital economj 7 . 

While thus this ammoniacal and superalkaline 
dyscrasia may originate and increase the virulence of 
all the malignant forms of disease, it also often 
complicates, intensifies, and corrupts all other diseases 
of an ordinarily benign character — both local and 
general. Thus by its irritant, solvent, toxemic, 
septicemic, and dissolutive action, it increases the 
tendency to, and complexity of, inflammatory, hemor- 
rhagic, albuminous, lymphoidal, serous, and purulent 
degeneration, disorganization, colliquation, and ex- 
travasation in general. For instance, in srnall-pox 
augmenting the pyrexial, necremic, septicemic, con- 
fluent, and purulent disposition, deliquescence, and 
malignancy, with, likewise, the same in all the ex- 
anthemata, and correlative maladies. While, in an- 
gina, bronchitis, pneumonia, consumption, and cog- 
nate affections inducing the same general typhoidal 
diathesis and dissolutive disposition, with spticemic, 
hemorrhagic, gangrenous, suppurative, and purulent 
tendency. Likewise in cerebritis, cerebro-spinal 
meningitis, gastritis, hepatitis, enteritis, metritis, 
nephritis, phlegmasia dolens, and other internal with 
external phlegmasie, causing a similar toxemic, 
pyemic, gangrenous, and disorganizing type, which 



62 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

are also manifested in the minor disorders of the 
surface in carbunculoid furunculi, erysipelatous 
wounds and abrasions, bruises, burns, injuries, 
punctures, and scratches, that otherwise would be 
mild and readily heal, with various purpuric, hsemor- 
rhoeal, albuminoid, serous and choleraic defluxions 
within the interior as well as from the surface of the 
body, and intestinal, renal, vaginal, and other tissues 
and passages. Indeed, it thus gives a scorbutic, 
necrsemic, septic, erysipelatous, infectious, and malig- 
nant type to every form and variety of disorder, from 
the simplest pimple, bruise, abrasion, or lesion — 
internal or external, up to the gravest diseases. Thus, 
in fact a general depraved cachexia and tendency 
is thereby excited to scorbutic, toxemic, septic, 
necrsemic, contagious, congestive, apoplectic, hemor- 
rhagic, albuminous, uremic, anasarcous, serous, 
eczematous, erysipelatous, gangrenous, purulent, 
mephitic, and disorganizing forms of disease — both 
genera] and local. Hence, in all such ammoniacal 
and superalkaline diatheses and complications, am- 
monia and its compounds are necessarily contraindi- 
cated, the opposite neutralizing, antalkaline agents 
being essential to subvert and counteract its toxic, 
morbific, and dissolutive effects. 

With regard to the relation of ammonia to bacteria 
and contagious affections, Dr. Geo. M. Sternberg 
observes in his report to the National Board of 
Health (Sanitarian, Dec. 6, 1883) : 

"The term albuminoid ammonia much used in the 
analysis of air, as well as of water, has usually 
represented a whole series of unknown factors. 

" It was first noticed by Gay Lussac that all the 
nitrogen of organic matter, when heated with caustic 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 63 

hydrates, appeared as ammonia. Albuminoid com- 
pounds, when disorganized by the growth of the 
lower forms of organisms, set free ammonia, and the 
quantity of the freed ammonia may in a general way, 
serve as a standard to indicate the amount of decom- 
position which has taken place. 

" The term albuminoid ammonia, on the contrary, 
stands for the quantity of nitrogenous material in air 
and water which may serve as food for the growth of 
these infinitesimal organisms. This as yet undecom- 
posed organic matter is not by any means in itself 
necessarily hurtful, although always objectionable. 
Combined with moisture at ordinary temperatures, it 
furnishes the condition for bacterial growth and may 
prove sufficient for the development and spread of 
an epidemic of some one of the class of contagious 
diseases. We can have no chemical test for dis- 
criminating between hurtful and harmless organic 
matter, since the poisonous infection is vital, and 
where found must be looked upon with suspicion." 

But, it is obvious, that these microzoa cannot be 
developed or exist without their essential nutrient 
material for organization and support — ammonia or 
its nitrogenous equivalent, and according to the 
abundance of this so will be their increase, activity, 
and power; and, per contra, its absence or diminution 
will proportionably prevent the appearance and limit 
their growth and energy, so that they must necessarily 
be secondary and subordinate factors of this basic 
ammoniacal source of disease, infection, and dissolu- 
tion. Yet, even admitting the primary action of 
microzymes in the production of ammonia and 
zymotic diseases, a safe and appropriate chemical 
treatment will both neutralize this alkali, starve and 

o 



64 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

kill them directly and indirectly, as well as resolve 
their morbid concomitants, thus nullifying the basic 
and initial factors of these pestilential and allied 
diseases, with the concomitant infectious principle 
and microbes, and the so common complication of the 
same malignant pathogenic causes with the usually 
benign abnormities, which thereby render them 
likewise infectious and destructive when they would 
otherwise remain innocuous. 

Further evidence of the spontaneous origin, basic 
chemical nature, and identity of the primal ammonia- 
cal cause of all zymotic, septic, malignant, infectious, 
and cognate diseases, might be largely adduced, such 
for instance, as are presented in an interesting paper 
on the " Community of Origin of Diphtheria, Typhoid 
Fever and Scarlatina/' (Journal American Medical As- 
sociation, August 30, 1884), by Dr. E. 0. Bardwell, of 
Malone, 111., which, he says, " appear to me to 
support the proposition that these three disorders owe 
their origin to a common source, that the same nidus 
may cause at one time the evolution of one malady, 
and at another time of a different one. What the 
peculiar predisposing force consists of which favors 
the production of one disease in preference to 
another, it is impossible to say, although various 
hypotheses with pages of text to support them might 
easily be written." 

The examples presented are too lengthy for quota- 
tion, but they all tend to prove the causal identity of 
origin and spontaneous development of diphtheria, 
scarlatina, and typhoid fever in isolated hamlets, 
apparently induced by insanitary conditions within 
and about the dwellings, engendering ammonia, 
malaria, and infectious matter, far away from any 
secondary sources of contagion. 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 65 

He further observes "judging from these cases I 
cannot arrive logically at any other conclusion than 
that these diseases are originally caused by disregard 
of the laws of hygiene. Their spread after develop- 
ment is another question entirely, and one with 
which we have at the present time no concern more 
than to venture the remark that the innocent in- 
evitably suffer with the guilty; the person whose 
doors are kept clean suffer the penalty of allowing 
their neighbors to live in ignorance of plain sanitary 
laws. If improper sanitation is the primordial factor 
in the evolution of these disorders, then it is not so 
important to ascertain in just what form and by what 
means disease is disseminated, as it is to strike at the 
root of the evil, to annihilate the first cause, without 
which there can be no elements of disease to be 
carried about by the air, by innocent micro-organisms, 
or by distinct varieties of minute life created for this 
special purpose/' 

Other examples might be cited of similar spon- 
taneous development of pestilential diseases, for, as 
correctly observed by Dr. N. S. Davis (Ibid), " It 
would be easy to find thousands of isolated farm- 
houses resting upon soil impregnated with the drip- 
pings of the kitchen, the cesspools, and the barnyard, 
and in which typhoid fever, diphtheria, scarlatina, 
etc., are almost annual visitors." These predisposing, 
and often also exciting causes of ill health and disease 
of various kinds, even of the most malignant type, 
are largely avoidable, for " it would be a compara- 
tively easy task for a large proportion of our farmers 
and inhabitants of villages, to turn all the contents or 
drippings of the cesspools and barnyards, through 
drainage pipes to neighboring cultivated fields, where 



66 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

it would increase the harvest in the very act of 

undergoing effectual epuration For say 

what we please about the seeds or germs of disease 
and the laws of their diffusion, it is certain that none 
of them thrive well in impure air accompanied by 
pure water and a clean soil." — {Ibid,) 

But, even after all these general impurities and 
sources of ammonia, malaria, disease, and pestilence 
are removed, there still remains the active, ever- 
present, insidious, special factors of morbidity, cor- 
ruption, and death from vicious habits and personal 
contamination of the people themselves, many of 
whom not only poison themselves but others, for, 
despite the utmost efforts to keep the blood and 
body pure and clean, any one may be befouled and 
suffer from the pernicious practices and toxic emana- 
tions from those who disregard the laws of health, 
and the rights of all persons to be free from enforced 
pollution, sickness, affliction, and death, w r hich bane- 
ful infliction is so markedly exemplified in the general 
production and diffusion of that most noxious and 
disease-generating tobacco miasm by smokers almost 
everywhere in public as well as in private, without 
the least regard for the rights, health, and lives of 
their fellow-beings, and which can only be obviated 
by a rigid observance and enforcement of personal 
with public sanitation. 

Moreover, decomposing nitrogenous matter and 
doubtless also ammonia favor the formation of those 
lately discovered poisonous alkaloidal substances 
termed ptomaines, which were thought at first to 
be exclusively of cadaveric origin, but as stated by 
R. N. Wolfenden, M. B., Lecturer on Physiology in 
the Charing Cross Hospital Medical School (Lancet, 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 67 

and Journal American Medical Association), " Investiga- 
tions are rendering it more and more probable that 
alkaloids of a poisonous nature occur in certain 
pathological conditions, and possibly also normally 
as a product of change of living tissue. Selmi sup- 
posed them to be products of putrefaction of organized 
nitrogenous material. 

" There can be no further doubt that these bodies 
are largely produced in the process of decomposition 
of nitrogenous or proteid tissues. There are many 
varieties of them and they vary much in their nature, 
according as the length of time after death is long or 
short. Stinking fish, bad meat, etc., all contain 
poisonous principles which can be extracted after the 
manner of ptomaines. The gastro-intestinal irritation 
and profound toxic symptoms produced by the inges- 
tion of bad food are probably at the bottom processes 
of alkaloidal poisoning. By decomposition of neurin 
and albumin toxic bodies may be obtained much 
resembling muscarin. Both from freshly prepared 
peptone made by the action of gastric juice on pure 
fibrin, and from stinking peptone by boiling with 
caustic soda, evaporating, extracting and purifying, 
toxic alkaloids can be obtained which kill frogs and 
rabbits in a few minutes. Putrefying casein, brain 
substance, liver and muscle also yield these products. 

" These ptomaines are met with as a constituent of 
normal tissues or juices. In this case they are pro- 
ducts of tissue metamorphosis." - They are also found 
in the saliva and urine. Likewise " in certain patho- 
logical conditions. In the urine of patients suffering 
from progressive paralysis there are two volatile 
bases, the one like nicotin, the other like coniin. 
In the urine voided during a case of interstitial 



68 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

pneumonia were two alkaloidal bases one having the 
odor of stinking fish, the other of ammonia. Two 
similar bases were found in the urine of patients with 
abdominal typhus. In tetanus a base like coniin was 
discovered in the urine. In the urine of ' miliary 
fever' an alkaloidal base having the odor of stinking 
fish has been observed. 

" Some of these ptomaines are not poisonous, but 
most possess strongly toxic characters, and cause 
profound symptoms when injected under the skin, 
such as paralysis more or less complete, of hinder ex- 
tremities, dilatation of pupils, convulsions, muscular 
flaccidity, slowing or acceleration of the heart, loss of 
cutaneous sensibility and of muscular contractility, 
possessing many of the characteristic physiological 
actions of muscarin or atropin. They answer to 
nearly the same reactions as the vegetal alkaloids." 

It is thus seen that an ammoniacal, superalkaline, 
dissolutive, and corrupt state of the living organism 
is not only favorable for the development of microzy- 
mes, but also a class of poisonous alkaloidal sub- 
stances, and doubtless likewise of the most virulent 
forms of contagia as well as of the milder varieties of 
infectious and toxic matter, with the spontaneous 
origin of all the varied zymotic, septic, contagious, 
and mephitic maladies, with the scorbutic, typhoid, 
infectious, and putrescent complication of all the 
minor and ordinarily innocuous disorders — both 
general and local, internal and external, of every 
grade and character, for while this primal obnoxious 
and morbific agent — ammonia, is thus always the 
same, the secondary and complicating poisons and 
concomitants, or contagious principles, pathogenic 
influences, and morbid states may vary indefinitely 
according to special conditions and complications. 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 69 

These considerations are of paramount importance 
for the correct appreciation of the aetiology, pathology, 
and treatment of all diseases of every form and 
nature, contagious and non-contagious, and especially 
of that infectious, malignant, and destructive variety 
of which diphtheria is a type. Without therefore, 
disregarding the presence of microzymes with toxic 
and other subordinate concomitants in diphtheria and 
correlative diseases-, yet in the prevention and treat- 
ment thereof they should be regarded as of secondary 
rather than of primary importance, while special 
effort should be made to subvert the basic chemico- 
organic and dynamic morbific factors, and particularly 
the primal ammoniacal pathogenic substratum, with, 
at the same time, destruction of infectious and toxic 
matter, extinction of the parasitic micro-organisms, 
and other probable causes of zymotic, contagious, and 
septic diseases, as true sanitation and therapeusis 
require extirpation of all elements of disorder or 
pathogenic causes — primary and secondary, with the 
use of all means of preserving and restoring health in 
the most certain and positive manner. What these 
specific measures are we will now proceed to show in 
the prevention and treatment of diphtheria, typhus, 
and all other zymotic, septic, infectious, scorbutic, 
putrescent, mephitic and allied diseases. 



70 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 



III. 

TREATMENT. 

While in general a priori, it would not seem prob- 
able that any single remedy or class of agents would 
prove specific in the cure of diphtheria, typhus, 
remittent, and other malarial, zymotic, septic, con- 
tagious, scorbutic, putrescent, colliquative, and 
cognate diseases, especially with widely diverse local 
lesions, from their apparently distinct and complex 
pathology and the consequent varied indications for 
their treatment, yet investigation and experience 
prove that such is largely the case. It is thus shown 
that there are single agents and a class of substances 
that prove more or less specific in the prevention and 
cure of these infectious and malignant diseases, by 
their disinfectant, antitoxic, antizymotic, antiseptic, 
antalkaline, neutralizing, resolving, and restorative 
properties, in destroying, nullifying, and subverting 
the morbific principle and underlying conditions upon 
which their occurrence and existence depends, and 
thereby jugulating the basic aetiological factor ab origo, 
as well as aborting and resolving its morbid sequelae. 
From the preceding exposition of the the basic 
ammoniacal, superalkaline and toxemic aetiology and 
pathology of these diseases, such specific remedies 
and treatment would naturally and logically be indi- 
cated in the antalkaline, neutralizing, disinfectant, 
antiseptic, antizymotic, antiscorbutic, resolving, and 
restorative agents included in the class of Acids, 
vegetal, animal, and mineral, of which the last are in 
general the most active, and, independent of all such 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 71 

^etiological and pathological considerations, prophylac- 
tive and therapeutic experience have shown their great 
practical efficiency in preventing and resolving these 
septic, infectious, and malignant maladies with the 
minor abnormal analogues. Of the mineral acids, 
hydrochloric and nitric acids separately, or combined 
in the nitro-hydrochloric acid, are the most generally 
efficient, though it is probable that hydrobromic acid 
will also prove very useful to some extent in the 
asthenic as well as sthenic disorders, to which latter it 
is most applicable. 

Hydrobromic Acid is antalkaline, antipyretic, re- 
frigerant, disinfectant, antizymotic, antiseptic, anaes- 
thetic, antispasmodic, and resolvent, with a special 
soothing, depurant, and relaxing effect upon the 
throat, air-passages and alimentary canal, properties 
particularly desirable to a limited extent in diph- 
theria, scarlatina, yellow fever, and correlative dis- 
eases, though in general, a more invigorating treat- 
ment is required therein from their asthenic character, 
yet, in all sthenic stages and types of fevers, anginose, 
and gastro-enteric affections, with allied conditions 
this agent is strongly indicated. 

"Like the bromides it has been successfully em- 
ployed in a variety of nervous disorders induced by 
reflex irritation, such as vomiting, cough, muscular 
spasm, whooping-cough and neuralgia, and in coughs 
excited by bronchial or laryngeal irritation. In cases 
also of cerebral hypercemia due to excessive mental 
activity in study, business, etc., it, appears to have the 
same influence as the bromides. In tinnitus aurium 
and other subjective sensations in the ear, especially 
those of a throbbing or knocking character, depend- 
ing upon vascular congestion, the medicine has 



72 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

proved very efficient." — (National Dispensatory). Of 
the dilute acid, dose from thirty minims to one fluid 
drachm in sweetened water or other appropriate 
vehicle, taken through a non-corrosive tube, as indi- 
cated, it being caustic in a concentrated state like its 
analogues. 

But, chlorine alone, or in some of its combinations, 
if not the best, is certainly a most powerful disinfect- 
ant, antalkaline, antiseptic, and germicide, with 
other active sanative properties, especially in the form 
of acids, and, for internal exhibition is most generally 
applicable and efficient in hydrochloric and nitro- 
hydrochloric acids, a brief resume of the medical 
properties of w 7 hich we will present in order to show 
more clearly their special value in the prevention and 
treatment of diphtheria, typhus, ship, yellow, malarial, 
and other fevers, with small-pox, scarlatina, and all 
other zymotic, septic, contagious, mephitic, putres- 
cent, and scorbutic diseases. 

Hydrochloric Acid, Strong muriatic acid is a powerful 
escharotic, hence must be freely diluted for internal 
use. It is antalkaline, disinfectant, antiseptic, anti- 
zymotic, refrigerant, febrifuge, resolvent, tonic, 
depurant, alterative, digestive, mild cholagogue, 
secernant, and laxative. It allays thirst and fever, 
improves the tone of the digestive organs, liver, and 
bow 7 els, promotes digestion, nutrition, secretion, and 
defecation, purifies the blood, destroys noxious sub- 
stances w r ithin, and favors the elimination of effete 
matter from the body. It is an efficient germicide, 
and u is regarded by Dr. Paris as an effectual pre- 
ventive to the generation of intestinal worms," 
(Waring 9 s Practical Therapeutics), who also "has given 
it w T ith success in malignant cases of typhus and 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 73 

scarlatina administered in a strong infusion of quassia. 
[t may also be added with advantage to infusions of 
3olombo, gentian, and cinchona. It proves a good 
adjunct to gargles in ulcerated sore-throat and 
scarlatina maligna/' — {United States Dispensatory). 

" In Typhus and Typhoid Fevers, the internal use of 
Hydrochloric Acid appears to prove highly service- 
ible. In an epidemic of Typhus Fever which pre- 
vailed in Stockholm in 1841-2, Prof. Huss states that 
this acid was the most relied upon, particularly in 
3ases attended with cerebral symptoms. He em- 
ployed a mixture composed of f5j of the acid in 
fgxij of decoction of Mallows, in doses of a table- 
spoonful every two hours. It was given in the earliest 
stage (after a purgative) and persisted in so long 
as the pulse continued full, firm, or compressible, 
and the sounds of the heart remained normal, or the 
first sound shorter than in the natural state. Its 
employment was not contraindicated by the state of 
the tongue, or of the gastric organs; it was given 
whether the tongue was loaded or not, red and fissured, 
moist or parched ; it was given also whether the 
abdomen was painful or not, tense or flaccid; in 
constipation and in diarrhoea. The sole contraindication of 
its use was bronchial or pulmonary congestion, which 
was aggravated by it. Phosphoric acid was substi- 
tuted when the pulse began to lose its fulness. For- 
dyce, Paris, and others bear testimony to its great 
value." 

" In the continued Fevers of Children, it appears to 

have a beneficial influence In scarlatina, 

Dr. McSherry speaks highly of Hydrochloric Acid in 
doses of gutt. j-iij, largely diluted. He regards 
purgatives as injurious." {Waring' s Practical Thera- 
peutics). 



74 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

As muriatic acid promotes the action of the 
stomach, liver, and bowels, purgatives in con- 
junction therewith are generally unnecessary, and 
often detrimental in the exanthemata and morbid 
conditions to which it is applicable, though laxatives 
may sometimes prove useful in moderation, while in 
gastro-intestinal fluxes, except in conjunction with iron 
and other constringents, it is mostly contraindicated, 
the astringent acids being more appropriate therein. 

Hydrochloric, in combination with Nitric acid 
forms a most powerful and valuable medicinal agent, 
and as nitric acid is of itself a potent remedy in like 
diseases, we will premise some general observations 
thereon, before treating of this compound acid. 

Nitric Acid, in a concentrated state is powerfully 
caustic, but when properly diluted is a safe and effi- 
cient medicament. It is antalkaline, disinfectant, 
antizymotic, antiseptic, antiperiodic, antipyretic, re- 
frigerant, febrifuge, alterative, resolvent, sialagogue, 
cholagogue, secernant, laxative, and tonic. It is 
especially useful in intermittent, with all malarial, 
putrid, infectious, and other adynamic fevers, whoop- 
ing cough, constitutional syphilis, chronic hepatitis, 
torpid liver and concomitant constipation, chronic 
affections of the spleen, and inactivity of the secretions 
and system in general. 

" If continued for a long period it causes salivation ; 
it has also apparently a more direct action on the liver 
than other acids, but it disagrees with the stomach 
sooner than Sulphuric Acid. It is an excellent 
alterative after long courses of Mercury, renovating 
the strength, and improving the tone of the system in 
a remarkable manner. As it acts injuriously on the 
teeth, any medicine containing it should be sucked 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 75 

through a quill or glass tube, and the mouth should 
be rinsed out with an alkaline solution after each 
dose/ 5 — Waring- \s Practical Therapeutics. 

Nitric acid is especially applicable in diphtheria, 
cynanche maligna, scarlet, bilious, remittent, typhus, 
ship, yellow, and other fevers, with small-pox, 
the exanthemata, septic, infectious, and putrescent 
diseases generally, both constitutional and local. It 
is very useful as an application to haemorrhoids, 
indolent, phagadenic, gangrenous, and sloughing 
ulcers, particularly cancrum oris, and like ulcerations 
of the mouth, gums, and throat, in full strength or 
diluted as required. In doses of from five to twenty 
minims of the dilute acid in three or more fluid 
ounces of sweetened water or lemonade it forms an 
excellent acid drink, and, at the same time, service- 
able disinfectant and stimulant lotion for the oral and 
faucial surfaces, as well as the gastro-intestinal canal, 
especially applicable in local complications thereof, 
with septicaemia and systemic atony, as in diphtheria, 
or malignant anginose affections, bilious, yellow, and 
other fevers, with similar disorders, both contagious 
and non-contagious. 

Nitric acid is very active as a fumigating and 
disinfecting agent, yet not considered equal to chlo- 
rine, though in its absence, or in conjunction therewith 
and chlorinated compounds it may be resorted to 
with advantage. The fumes are readily evolved by 
pouring sulphuric acid upon nitre in an earthen dish 
upon heated sand. It is, however, in combination 
with the hydrochloric acid as nitro-hydrochloric acid, 
that it is of superior value, as this combines the most 
useful properties of its constituents with additional 
ones of greater utility both in medicine and the arts. 



78 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

in connection with the other mineral, animal and 
vegetal acids, and doubtless with as decided beneficial 
effects in the former as in the latter. 

But, while perhaps, I have applied this acid treat- 
ment most generally and freely from the theory of the 
chemico-organic, ammoniacal, or superalkaline origin 
of these scorbutic, zymotic, septic, contagious, 
putrescent, and correlative diseases, and present it as 
the true basic and specific treatment therefor, its 
value does not rest upon my own limited experience 
alone, as the correlation of the superalkalinity of the 
blood with low fevers and the usefulness of the 
mineral acids in their treatment, has long been recog- 
nized to a certain extent. 

Thus, according to Dr. Headland (Action of Medi- 
cines), " The natural alkalinity of the blood is due to 
the presence of free Soda and Ammonia." . . . 
" A free acid may act as a Restorative in cases where 
there is an excess of alkali in the blood. It may either 
remain in the blood after entering into combination, 
or it may pass off by the urine, supplying there the 
place of a natural acid, which it leaves behind in the 
system. It is on such a theory as this that the action 
of mineral acids in typhoid and putrid fevers has been 
explained. Huxham long ago recommended acids to 
counteract the ' putrid crasis,' in fevers. They are 
certainly sometimes of marked service in these dis- 
orders. Dr. Murchison recommends the treatment 
of Typhus and Typhoid fevers by mineral acids. Of 
230 cases of continued fever in St. Mary's Hospital, 
Dr. Chambers treated 109 on 'general principles/ 
121 with Hydrochloric acid. Of the 109, 23 died; 
of the 121 only 4 died. i Continuous liquid nutri- 
ment,' of beef-tea and milk was given along with the 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 79 

Hydrochloric acid, (Med. Chir. Soc, April 28, 1863). 
Dr. Henderson found at Shanghai that the mortality 
from continued fever was reduced by the employment 
of the acid from 28 to 7 per cent. (Medical Times, 
March, 1863). Mr. Day, of Stafford, has found nitric 
acid of great use in malignant scarlatina. In the 
Yellow fever of tropical climates, an excess of alkali 
was discovered some years since by Dr. Blair. This 
alkali seems to be Ammonia. I do not affirm posi- 
tively that there is in all of these fevers an excess of 
alkali in the blood. Although likety, it is not proved. 
The explanation is plausible." 

Yet, this superalkalinity of the blood, mainly from 
Ammonia in these septic, contagious, and adynamic 
diseases, is almost positively demonstrated both ex- 
perimentally and therapeutically, as well as in their 
Btiology and pathology, from the free natural evolu- 
ion of this alkali within the body, and its artificial 
ntroduction from without into the system, with the 
r ell-marked and specific effects of the acid treatment 
herein. Besides other evidence which might be ad- 
luced, this was clearly exemplified in seventeen or more 
ases of Ship Fever which came into the Philadelphia 
lospital under my care at one time. These patients 
vere seriously ill, spotted with the maculae of typhus, 
md so offensive and contagious that it was dangerous 
o go near them, yet with the free administration of 
nineral and vegetal acids — nitro-hydrochloric acid 
>eing the principal, they were soon disinfected, 
mrified, revivified, and restored to health, every one 
ecovering, except one brought in moribund and 
lying before treatment could be instituted. 

Dr. Waring states (Practical Therapeutics), that " in 
Typhus Fever, the mineral acids have been recom- 
lended in all countries from the days of Forestus, 



78 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

in connection with the other mineral, animal and 
vegetal acids, and doubtless with as decided beneficial 
effects in the former as in the latter. , 

But, while perhaps, I have applied this acid treat- 
ment most generally and freely from the theory of the 
chemico-organic, ammoniacal, or superalkaline origin 
of these scorbutic, zymotic, septic, contagious, 
putrescent, and correlative diseases, and present it as 
the true basic and specific treatment therefor, its 
value does not rest upon my own limited experience 
alone, as the correlation of the superalkalinity of the 
blood with low fevers and the usefulness of the 
mineral acids in their treatment, has long been recog- 
nized to a certain extent. 

Thus, according to Dr. Headland (Action of Medi- 
cines), " The natural alkalinity of the blood is due to 
the presence of free Soda and Ammonia." . . . 
" A free acid may act as a Restorative in cases where 
there is an excess of alkali in the blood. It may either 
remain in the blood after entering into combination, 
or it may pass off by the urine, supplying there the 
place of a natural acid, which it leaves behind in the 
system. It is on such a theory as this that the action 
of mineral acids in typhoid and putrid fevers has been 
explained. Huxham long ago recommended acids to 
counteract the 'putrid crasis,' in fevers. They are 
certainly sometimes of marked service in these dis- 
orders. Dr. Murchison recommends the treatment 
of Typhus and Typhoid fevers by mineral acids. Of 
230 cases of continued fever in St. Mary's Hospital, 
Dr. Chambers treated 109 on 'general principles,' 
121 with Hydrochloric acid. Of the 109, 23 died; 
of the 121 only 4 died. < Continuous liquid nutri- 
ment,' of beef-tea and milk was given along with the 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 79 

Hydrochloric acid, (Med. Chir. Soc, April 28, 1863). 
Dr. Henderson found at Shanghai that the mortality 
from continued fever was reduced by the employment 
of the acid from 28 to 7 per cent. (Medical Times, 
March, 1863). Mr. Day, of Stafford, has found nitric 
acid of great use in malignant scarlatina. In the 
Yellow fever of tropical climates, an excess of alkali 
was discovered some years since by Dr. Blair. This 
alkali seems to be Ammonia. I do not affirm posi- 
tively that there is in all of these fevers an excess of 
alkali in the blood. Although likely, it is not proved. 
The explanation is plausible." 

Yet, this superalkalinity of the blood, mainly from 
Ammonia in these septic, contagious, and adynamic 
diseases, is almost positively demonstrated both ex- 
perimentally and therapeutically, as well as in their 
aetiology and pathology, from the free natural evolu- 
ion of this alkali within the body, and its artificial 
introduction from without into the system, with the 
well-marked and specific effects of the acid treatment 
therein. Besides other evidence which might be ad- 
duced, this was clearly exemplified in seventeen or more 
cases of Ship Fever which came into the Philadelphia 
Hospital under my care at one time. These patients 
were seriously ill, spotted with the maculae of typhus, 
and so offensive and contagious that it was dangerous 
to go near them, yet with the free administration of 
mineral and vegetal acids — nitro-hydrochloric acid 
being the principal, they were soon disinfected, 
purified, revivified, and restored to health, every one 
recovering, except one brought in moribund and 
dying before treatment could be instituted. 

Dr. Waring states (Practical Therapeutics), that "in 
Typhus Fever, the mineral acids have been recom- 
nended in all countries from the days of Forestus, 



80 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

Sydenham, etc. The theory of their action is obscure; 
but as Dr. Murchison observes, their beneficial effects 
are undoubted. Dr. Murchison adds (On Fevers, 
1862), that during the last few years he has used 
these acids in hundreds of cases, and he believes them 
superior to any other method of treatment, though far 
from ascribing to them the wonderful effects at- 
tributed to them by some writers. He states that he 
usually commences with the hydrochloric (tgjxx) and 
nitric acids (wrx) every three hours, each dose being 
diluted with the patient's drink. In the advanced 
stages of severe cases, when the ' typhoid state' is well 
marked, he prefers sulphuric acid (tnxv-xx). every 
three hours, with Ether and small doses of quinine. 
He states that he has often observed marked improve- 
ment follow the commencement of the acid treatment, 
at whatever stage of the fever it was prescribed, and 
although no wine or brandy was given with it. In 
Typhoid (Enteric) Fever, Dr. Murchison considers that 
no remedies are superior to the mineral acids, and 
that they are often of real service, though their powers 
have been overrated. Here he prefers the hydro- 
chloric and sulphuric acids, ^xv-xxx of the dilute 
acid every three or four hours. With each dose he 
combines about half a grain of quinine, believing it to 
be of great service, especially when the disease has 
anything of a remittent character." 

From the general character of the disease, the 
nitric, hydrochloric, nitro-hydrochloric, and other 
acids — mineral, animal, and vegetal, are specially 
indicated in the prevention and treatment of yellow 
fever, and if given freely therein will doubtless act as 
efficiently as in ship, typhus, remittent, adynamic, and 
putrid fevers generally, with other diseases of the 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 81 

same general class and nature. The mineral acids 
and particularly nitrohydrochloric acid are specific- 
ally adapted to meet the varied indications in yellow 
fever presented in the superalkaline, or ammoniacal, 
toxemic, septic, scorbutic, necrsemic, and hemorrhagic 
condition, pyrexia, jaundice, defective, vitiated secre- 
tion and torpor of liver, bowels, kidneys, and general 
economy, with thirst, sickness of stomach, tendency 
to black vomit, collapse and death, by neutralizing 
and destroying all the ^etiological factors, resolving 
their pathological sequelae, disinfecting and depurating 
the blood and body, restoring the normal chemico- 
organic operations, secretions, and functions of life, 
and refreshing and invigorating the entire system at 
the same time. 

The dilute nitro-hydrochloric acid may be given in 
doses of from v-xx minims properly diluted to a 
pleasant acid taste. In water, lemonade, infusion of 
barley, or other mild acidulous and bland liquid, 
sweetened to taste, it forms an acceptable, antalkaline, 
disinfectant, antiseptic, nutrient, restorative, and 
refreshing beverage, very agreeable and invigorating 
to those suffering with scorbutic, malarious, bilious, 
septic, febrile, infectious, and mephitic affections. As 
a nutritive diluent to promote its efficiency and 
increase the ingestion of acid, I usually give it with 
the juice of one lemon, in a goblet of sweetened water 
or other menstruum, as freely as required and the 
stomach will bear. To protect the teeth, it should be 
taken through a glass, porcelain, straw or other non- 
corrosive tube, and the mouth rinsed out subsequently 
with lime, or other alkaline and plain water, though 
in edentulus children and adults it may be directly 
taken without such precautions, its localized action 



82 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

on the mouth being often desirable, always avoiding, 
of course, its contact with metallic spoons or other 
neutralizing and contaminating substances. 

Phosphoric Acid, is also very efficacious in adynamic 
fevers and conditions and is particularly applicable 
when a more stimulant effect is required, and either 
alone or with orange, lime, lemon, or other vegetal 
acid juice in water, infusion of barley, lactic acid, 
buttermilk, coffee, tea or other appropriate men- 
struum, sweetened to taste, forms a very pleasant, 
refreshing, cooling, stimulant, restorative, tonic 
drink. It is especially useful in atonic conditions 
and low fevers, as it is antalkaline, and actively 
stimulates the brain, nervous, and vascular systems, 
while it reduces temperature, allays fever, and 
quenches thirst most effectually. It invigorates the 
general system, promotes secretion, nutrition, and 
depuration, and may be alternated advantageously 
with the more potent disinfectant and antiseptic 
mineral acids. 

11 In Typhus and Typhoid Fever it has been given with 
advantage. In the epidemic fever which appeared at 
Stockholm in 1842, Prof. Huss employed Phosphoric 
Acid in all the cases which came under his notice. He 
commenced its use when the pulse began to lose its 
fulness, and the first sound of the heart became short 
like the second, f Siij of the acid were diluted with 
fgxij of decoct, malvse; and of this one or two 
dessert spoonfuls were given every two hours." — 
( Waring' s Practical Therapeutics). 

But if necessary phosphoric acid may be exhibited 
more frequently and freely, being careful not to over- 
stimulate the brain, as it has a special tendency 
thereto, and may be generally employed, either alone 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 83 

or in combination, as phosphate or lacto-phosphate of 
iron, quinia, strychnia, lime, and soda, according to 
special indications, whenever a stimulant, tonic, anti- 
scorbutic, antiperiodic, and restorative is required. 
As a refrigerant, febrifuge, assuager of thirst, secer- 
nant, resolvent, depurant, stimulant, tonic, and 
restorative, or invigorant of mental, nervous, mus- 
cular, and general vital energy, phosphoric acid and 
its compounds are far superior to alcoholic liquors of 
any kind, which in fact, diminish secretion, excite 
and increase thirst, poison the blood both directly and 
indirectly, prevent depuration, induce scorbutic, 
toxemic, irritative, and adynamic fever, with ataxia, 
and depress rather than increase nervous, muscular, 
and vital tonicity, or mental and bodily strength, 
ample evidence of w T hich is presented everywhere 
throughout the world. 

Sulphuric Acid, though powerfully caustic when 
strong, is, properly diluted, a safe and valuable ant- 
alkaline, antipyretic, antiseptic, antizymotic, disin- 
fectant, refrigerant, astringent, styptic, and tonic. It 
is especially applicable in low fevers and infectious 
diseases, with haemorrhages, diarrhoea, choleraic and 
other defluxions, as well as in the less complicated 
forms of the latter generally. It is particularly useful 
in haematemesis and haemorrhage from the bowels, as 
well as from the lungs, uterus, and general surface, 
and hence is especially indicated in the gastrointes- 
tinal haemorrhages of yellow and typhoid fevers, with 
those of allied affections. In the, diarrhoea of typhoid 
or enteric fever, with choleraic and atonic defluxions 
generally, it is very serviceable. 

" In the Diarrhoea of Typhoid Fever, Dr. H. Kennedy, 
states, after ample experience, that by far the best 



84 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

remedy is diluted Sulphuric Acid (f 5 j to f 3 iij ad Aq. 

fgviij). It is best to begin with a small dose and 
increase it as required. The diarrhoea should not be 
too suddenly checked. Opiate enemas to allay 
tenesmus are to be used." 

" In the advanced stages of continued Fevers and in 
Typhus Fever, the internal administration of Sulphuric 
Acid, with some tonic infusion, appears to be of great 
service. Prof. Huss found that when there was 
profound prostration, with commencing bed-sores, 
and persistent diarrhoea, Sulphuric Acidin combination 
with Infus. Rosse or Infus. Arnicse mon. was productive 
of much benefit." 

" In Confluent Small-pox, when the pustules are 
filled with a bloody sanies, and the urine contains 
portions of broken down coagula of blood, dilute 
Sulphuric Acid is stated by Dr. Thompson to be a 
remedy of the highest value, indeed the only one 
that can be relied upon. Its use should be com- 
bined with wine, tonics, etc." — [Waring 9 s Practical 
Therapeutics). 

Sulphuric acid is also beneficial both constitutionally 
and locally, in scarlatina, ulcerated sore throat, ptya- 
lism, colliquative sweats, cholera, choleraic affections, 
and defluxions generally. Mr. Buxton, of London, 
attested in 1851 to the " remarkable efficiency of 
diluted sulphuric acid," and in 1853, Dr. H. W. 
Fuller, of St. George's Hospital u strongly recom- 
mended it in choleraic diarrhoea, from his own 
experience and that of his friends in more than ninety 
cases without a single failure. The dose employed 
was half a fluid-drachm, diluted with water, given 
every twenty minutes in ordinary cases, every quarter 
of an hour in severe cases. The vomiting, purging, 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 85 

and cramps usually ceased after the third or fourth 
dose." — ( United States Dispensatory). 

In passive diarrhoeas and other defluxions the 
aromatic, is preferable to the simple sulphuric acid. 
Both may be given in the compound infusion of roses, 
tea, or with gallic acid, cinchona', and other tonics, 
in doses of from ten to thirty drops in a wineglassful 
of plain or sweetened water, as often as required, 
sucked through a non-metallic tube with the same 
precautions to protect the teeth as the other mineral 
acids. 

Other acids, as sulphurous, carbolic, and salicylic 
acids, with their respective salts and combinations, as 
sulphites, sulpho-carbolates. salicylates, etc., of soda 
more especially, are more or less useful in zymotic, 
septic, contagious, mephitic, aud allied diseases, but, 
in general, are neither so safe, convenient, efficient, 
or pleasant to take, as the several mineral and vegetal 
acids indicated, with their compounds of iron, lime, 
soda, quinia, strychnia, etc. 

The predominent indications in the preventive and 
curative treatment of all zymotic, toxemic, septic, 
and contagious diseases, is to avert the production, 
abort, neutralize, and destroy the basic morbific 
alkaline agent, infecting principle, and concomitant 
poisons, disinfect and purify the body, the interior as 
well as exterior, every particle thereof, in its entirety, 
the vital economy within itself being an active 
generator as well as recipient of poisonous matter and 
contagium, and resolve the morbid lesions and com- 
plications. 

While the single elements chlorine, iodine, bro- 
mine, sulphur, etc., are active neutralizes of alkaline 
substances, germicides, disinfectants, antiseptics, 



86 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

depurants, and resolvents, they are not so eligible to 
exhibit medicinally as their compounds, especially 
the acids, though in some conditions may be usefully 
resorted to for special purposes, their protective and 
resolvent influence in these affections being very 
efficient. But, in general, the acids— mineral, vege- 
tal, and animal, are most useful as antalkalies, anti- 
septics, antizymotics, and for the disinfection and 
purification of the living organism, with other 
salutary purposes, particularly the citric, lactic, 
salicylic, carbolic, sulphurous, sulphuric, phosphoric, 
nitric, hydrochloric, and nitro-hydrochloric acid. The 
last is especially potent, not only in the milder 
disorders of a scorbutic, infectious, zymotic, septic, 
and mephitic character, but also in the most malignant 
and contagious, as typhus and scarlet fever, diph- 
theria, small-pox, and others of a like virulent type. 

From many years' experience in the more or less 
free use of these acids, hydrochloric and nitro-hydro- 
chloric, particularly, with the vegetal acids, in 
scorbutic, necrsemic, zymotic, septic, contagious, and 
mephitic diseases generally, for it has been my custom 
to exhibit them freely in all such maladies, I can 
strongly testify to their superior value as potent 
antalkalies, disinfectants, antiseptic, antizymotic, feb- 
rifuge, remedial, and sanative agents, both for pre- 
ventive and curative pcrposes in these dangerous and 
destructive affections so prevalent throughout the 
world. Thus, it is not only in those pernicious types 
of toxemic and typhoidal blood dyscrasia — as in the 
more purely ammoniacal or superalkaline, scorbutic, 
necreemic, septicaemic, and infectious conditions, that 
these acid remedies are so markedly efficient, but 
also in those systemic disorders with local lesions of 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 87 

various kinds from the extreme eruption of variola to 
the slightest local manifestation of a general super- 
alkalaemia and toxicosis, though when these are in 
the gastro-intestinal canal they must be given more 
circumspectly, and the more soothing, conservative 
and astringent acids selected, as in enteric fever for 
instance, so as to act most favorably upon the local 
affection of the bowels, neutralize the superalkalinity 
of the blood, destroy septic and contagious matter, and 
depurate and support the system at the same time. 
Hence in typhoid fever, cholera, and like affections 
with gastro-intestinal lesions, the milder and more 
astringent acids with their compounds are most 
applicable, as muriatic acid, chloride of iron, phos- 
phoric and sulphuric acids, with their combinations 
of phosphate of iron and lime, sulphate of iron, or the 
still more sedative hydrobromic acid, and bromide of 
iron and lime, carbolic, and sulphurous acid, and 
sulpho-carbolates, with their analogues, of acetic acid 
and acetates, etc., and corresponding vegetal acid 
principles, juices, and jellies, according to the special 
indications of irritation, inflammation, ulceration, 
heemorrhage, diarrhoea, etc., to thus most specifically 
counteract and overcome the local with the consti- 
tutional disorder, neutralize and destroy the basic 
alkaline and concomitant materies morbi in the blood, 
tissues, and section implicated, resolve the disease 
altogether, and restore the healthy integrity and 
tonicity of both the part affected and of the general 
system. 

But, notwithstanding this marked ammoniacal and 
superalkaline condition of system in typhoid fever 
and correlative diseases, as the primal cause thereof, 
it is strongly urged that ammonia is the sure remedy 



88 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

for the former. Thus, in an interesting paper on the 
Treatment of Typhoid Fever, read at the last meeting, 
and published in the Jour. Amer. Med. Assoc, August 
16, 1884, Dr. S. K. Jackson, of Norfolk, Va., after 
some general observations on its pathology observes: 

" Another possible, if not probable, cause of this 
nitrogenous waste of the system is due to the con- 
sumption of this important element by the parasitic 
organism which is the acknowledged serological 
factor in the production of enteric fever. That this 
microzoon is a nitrogen feeder, is evident from the 
fact that he lives and is developed in nitrogenous 
matters, in urea and all nitrogenous excreta. These 
furnish its peculiar pabulum, in them it is generated 
and thrives. Old timbers saturated with urea, the 
rotted logs of a country cabin against which men 
have constantly micturated, have been known to be 
fruitful sources of this disease. The most serious 
outbreak of typhoid fever I have ever known, occur- 
red during our late war (1862), in a Mississippi 
brigade, who were encamped at the foot of a mountain 
slope where a large amount of leaf mould had been 
for years accumulating. This spongy mass when 
saturated with their urinary deposits, and probably in 
a state of fermentation, caused the most malignant 
epidemic of this disease that has ever occurred in my 
experience. I hope some day, to obtain access to the 
official records to ascertain the great numbers who 
fell victims to it; they are numbered by hundreds. I 
hope I may be pardoned for mentioning here, that of 
223 cases that were taken under the treatment I am 
now advocating, not one died." .... 

" If further proof be needed that this microzoon is 
a consumer of nitrogen, it is furnished by the am- 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 89 

moniacal exhalations emitted by "a typhoid fever 
patient, from the breath, the skin, as well as by the 
urine, which, when freshly passed, as is known to all, 
emits the odor of ammonia, like stale urine in a state 
of decomposition." 

" These exhalations are undoubtedly due to the 
decomposition of the nitrogenous constituents caused 
by this micro-organism."* .... 

" It is clear then that our aim should be to supply 
this nitrogenous waste. How is it to be done ? By 
nitrogenous food, you will say; a very rational way 
of accomplishing that desirable end, were it not for 
the utter impossibility of digesting and assimilating 
this food.f There is only one way, known to me, of 
effecting this purpose, and that is by the free adminis- 
tration of ammonia, even to saturation. 

" Fortunately this nitrogenous base furnishes us 
with salts of such different therapeutical powers that 
we have no difficulty in finding one adapted to any 
and every stage of the disease and every probable 
condition of the patient during its existence or 
progress. It supplies us in the nitrate with the most 
sedative salts we possess, and in the carbonate, with 
the most stimulant salt in our Materia Medica. The 
only other salts of ammonia'I have been in the habit of 
using in the disease are the acetate and hydrochlorate, 
in conditions which will be presently pointed out." 

Still, notwithstanding the high degree of success in 
the treatment of typhoid fever, with these salts of 

* Or rather, that the development and activity of the microzymes 
are due to the excess of ammonia, their pabulum vitae. 

f But food may be artificially digested by acids, pepsin, etc., 
and its assimilation promoted by oxygenating and other corrobo- 
rating agents. 



90 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

ammonia this alkali is obviously contraindicated in 
this disease, while the constituent acids of its com- 
pounds, which are usually in excess therein, are 
especially applicable as neutralizing, antalkaline, 
antiseptic, antipyretic, antizymotic, disinfectant, and 
corroborant agents. Besides, instead of increasing 
the already excessive solvent and irritant ammonia in 
the system and further tending to its destruction by 
colliquation and otherwise, as well as to augment the 
undue alkaline pabulum promotive of the develop- 
ment and activity of the parasitic microzoa, thus 
doubly taxing the struggling economy to expel this 
alkali, which is being conservatively eliminated at 
every pore, and resist at the same time, the destructive 
action of the concomitant sepsin, infection, and 
microzymes, a more rational method would seem to 
be to exhibit such agents as would subvert the 
production, neutralize, and counteract the ill effects 
of this noxious alkali — ammonia — in excess, nullify 
its morbific sequents, and starve and destroy the 
accessory microzoa, which can be most readily 
effected by acid, antalkaline, antizymotic, antiseptic, 
disinfectant, resolvent, and restorative medication and 
alimentation. 

The general tendency of preventive and curative 
medicine is in this direction, and clinical experience 
is demonstrating that it is the only true and specific 
method of treatment of typhoid with all allied diseases. 

Thus among others that might be cited in proof 
thereof, Dr. D. A. Sheffield, of Apple^River, 111., after 
inviting attention to salicylate of bismuth as presented 
by Prof. Henri Desplats, as " the great desideratum' 5 
in enteric fever {Med. Record), highly commends 
sulphurous acid in this class of diseases, and states 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 91 

{Jour. Amer. Med. Assoc), "A course of experimen- 
tation with the drug, extending through a period 
of more than twenty years, in almost every variety 
of zymotic disease, convinces the writer that its 
power over and adaptability to the medication of 
this variety of ailment has not been recognized and 
appreciated by the majority of the profession." 

" That it is capable of modifying both the violence 
and duration of typhoid fever, has been demonstrated 
to my own and my patients' satisfaction so many 
times, that without the drug I should approach the 
treatment of a case of that disease with considerable 
trepidation. Given in moderate doses during the 
period of dry skin and parched brown tongue, its 
effects are often magical. 

"This disease, however, is but one of the many in 
which sulphurous acid may be used both as a remedy 
and a prophylactic. The acute infectious diseases are all 
modified, aborted, or wholly prevented by its use J' 

Bisulphite of soda has been mostly exhibited 
"though in a few cases a solution of sulphurous acid 
diluted with glycerine has been employed, giving 
equally as good results, but not as well tolerated by 
the patient." 

" To demonstrate its utility use a saturated solution 
of bi-sulphite of soda in water, giving one teaspoonful 
every two or three hours until the system is brought 
fully under the influence of the drug; afterward one 
dose every six hours will be sufficient to maintain its 
effect." 

The sulpho-carbolate of soda has also been found very 
serviceable in these diseases, and the corresponding 
salt of lime, or sulphite of lime singly, will doubtless 
also prove useful therein, the carbolic acid being 



92 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

likewise a "potent antalkaline, antiseptic, and germi- 
cide, while the lime promotes the healing of local 
lesions and the reconstruction of tissues. But, for 
this purpose the phosphate of lime with the acid in 
excess is most useful as a nutrient, antalkaline, and 
stimulant to the nervous and general system. 

Iodine has also been highly commended in the 
treatment of typhoid fever, but, as it is a disintegrant 
and sorbefacient as well as local irritant, it has a 
tendency to promote intestinal excitement, morbid 
waste and emaciation, already too active, hence is 
contraindicated therein, and especially in combination 
w 7 ith potassium w 7 hich increases the superalkalinity, 
solvent, scorbutic, and dissolutive condition of the 
blood and body, depresses the heart, nervous and gene- 
ral system, and still more favors the concomitant 
inanition and prostration of the disease. The sodium 
salt is far better when a resolvent is required, and 
ordinarily better still the iron compound of iodine, 
the syrup particularly. But chlorine and bromine 
with their compounds are far more conservative, 
reparative, and applicable than iodine, in this and 
correlative disorders, especially in their acid form, as 
well as with iron, soda, and lime, the bromides of 
iron and lime particularly for their local soothing and 
healing effects upon the gastro-intestinal canal, while 
bromide of quinia — when the latter is required, is less 
exciting than the sulphate, this salt combining the 
mean of the valuable properties of its constituents. 
Yet, while hydrobromic acid is a potent febrifuge and 
calmative, it, with the bromides except that of quinia 
and its analogues, are rather too sedative for free use 
in this disease, as in general, a more supporting and 
invigorant treatment is needed therein. Hence, as a 



DIPHTHERIA. TYPHOID, AND ALLIED DISEASE-. 93 

most active antalkaline, antiseptic, refreshing stimu- 
lant, tonic, analeptic, corroborant, and restorative, 
phosphoric acid and the phosphates of iron and lime, 
with sometimes, quinia and strychnia, the latter often 
better subcutaneously, are invaluable in enteric fever 
and cognate diseases, employed judiciously according 
to special indications, singly or in conjunction with 
other remedies as required by the varying conditions 
and exigencies of the cat Moreover, when an 

actively diffusible stimulant is necessary therein, 
instead of the obnoxious alcoholic liquors usually 
freely exhibited, the oil of turpentine is far better 
in every respect — internally and externally, by inhala- 
tion, deglutition, and otherwise. While for alimentary 
purposes, peptonized milk and lime water or sulphite 
of lime, with corresponding light albuminoids, and 
the astringent acid fruit juices and jellies form the 
basic and principal food, as the stomach and chylo- 
poietic viscera are incapable of much digestive effort 
in this affection and cognate disorders. 

Thus, the local lesions and manifestations with the 
-temic dvscrasia of these varied scorbutic, necraemic. 
zymotic, septic, contagious, malignant, colliquative, 
and adynamic maladies, may require a modification 
of this basic acid treatment, without, however, chang- 
ing its essential character, with the addition of other 
compatible remedies to meet the special indications 
in the different phases and complications thereof, but 
all of which are more or less directly dependent upon 
the underlying ammoniacal, superalkaline, toxemic, 
septic, and constitutional derangement. Hence, in 
general, the acids and their analogues, by neutraliz- 
ing, subverting, and destroying the primal superin- 
ducing ammoniacal or alkaline cause and condition, 



94 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

undermine, nullify, and resolve at the same time their 
concomitant toxic and morbid sequelae, 

Besides the many minor manifestations of its power 
the efficacy of this acid and antalkaline treatment is 
strikingly exemplified in that formidable exanthem — 
variola. In the virulent superalkalinity, septicaemia 
and toxicosis of smallpox, with the extensive erup- 
tions on the surface of the body, the mineral and vege- 
tal acids are remarkably efficient as antalkaline, anti- 
septic, disinfectant, alterative, tonic, resolvent, and 
curative agents. The carbolic, sulphurous, sulphuric, 
and salicylic acids have been thus highly spoken of 
in the resolution and cure of variola, with allied 
septic and contagious diseases. According to my 
own experience the hydrochloric and nitro-hydro- 
chloric acids act as basic and specific resolvents 
of both the constitutional malady and local lesions 
in small-pox as well as in cognate abnormities, 
as they neutralize the superalkalinity of the organic 
fluids and solids, disinfect and depurate the blood 
and genera] system, destroy the septic and infect- 
ing virus, and nullify the underlying amrnoniacal 
cause, thereby subverting the basic exciting factor of 
the dyscrasia, pestiferous condition and eruption, 
inducing their speedy subsidence, and exterminating 
the materies morbi, contagious principle and disease 
at the same time. In particular, nitro-hydrochloric 
acid is very active as a prophylactive and curative 
agent in aborting the variolous disease altogether 
when taken in time, and cutting it short after its 
inception, by neutralizing the basic superalkaline 
pathogenic factor, breaking up the primary fever, 
preventing the eruption, checking suppuration, drying 
up the pustules, disinfecting the blood and body, and 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 95 

destroying the contagium and noxious emanations. 
It may be given in conjunction with lemon juice and 
other vegetal acids as freely as the system will tolerate, 
in doses proportioned to the age and necessities of 
the case, in solution as previously indicated. Sour 
buttermilk may also be taken largely as both adjunct 
acid medicine and food with corresponding acidulous 
.medicaments and regimen. I believe I have thus 
aborted the prodromic fever of variola with this acid 
medication and alimentation, though of course, this 
is difficult to prove, as there must always remain a 
doubt whether it was not a casual or ephemeral fever, 
hence can only be settled by an extensive series of 
cases in hospitals and elsewhere under the most 
adverse circumstances. Therefore, I present this as 
my experience and belief to excite such a course of 
practical investigation for the prevention and subver- 
sion, as well as cure, of this terrible malady, though 
as nitromuriatic with other mineral and vegetal acids 
will suppress it, they should of course be able to 
abort it ab initio. 

The mineral, animal, and vegetal acids, especially 
the hydrochloric and nitro-hydrochloric acids thus 
appear to be effective preventives of, and most basic 
and specific remedies for, small-pox, with correlative 
maladies. Other preparations of chlorine, as chlorine 
water, chlorinated soda, chloride of iron and lime, 
chlorates of soda and potassa are likewise applicable, 
with doubtless also sometimes in the more sthenic 
stages, hydrobromic acid and the bromides of sodium 
and potassium, though the alkalies always with care 
from their liquefacient tendency ; but better usually 
in the asthenic and colliquative conditions, sulphuric 
and phosphoric acids, with their corresponding salts 



96 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

of iron, quinia, and strychnia, or lacto-phosphate of 
the same with lime. 

Oil of turpentine, oxygen, peroxide of hydrogen, 
nitrous oxide, and other stimulants, haemostatics, and 
corroborants are also indicated therein more or less 
freely according to special type, stage, and complica- 
tions of the disease, its general tendency being of an 
adynamic character. In general, the vegetal acids, 
citric, tartaric, acetic, etc., or better in the form of 
lime, lemon, orange, tamarind, and other acid fruit 
juice, jelly, and drinks, or vinegar properly diluted 
and sweetened, with stewed acid fruit and more sub- 
stantial food afforded in sour butter-milk and acid 
albuminoids are useful adjuncts to the acid mineral 
and other medicaments, and doubly beneficial as 
remedies and aliment in variola with like maladies. 

The same remedies, regimen, and principles also 
apply in the treatment of the exanthemata generally, 
as scarlatina, measles, etc., with the other septic, con- 
tagious and scorbutic diseases, in which they are very 
efficient, as I can testify from long experience there- 
with in such affectious, it being my invariable and 
basic practice therein from the successful results of 
their application. These mineral and vegetal acids, 
with acid food and fruit are also preventive as well as 
curative of such maladies. 

In the treatment of that correlative and fatal dis- 
ease — diphtheria, the mineral, animal, and vegetal 
acids, and especially the hydrochloric and nitro- 
hydrochloric acids, are also the basic and specific 
remedies, the local lesion and malignant affection of 
the throat being secondary and subordinate to the 
constitutional disorder which is dependent upon the 
ammoniacal, superalkaline, and toxic condition of the 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 97 

blood, with atony of the general system, though the 
pharyngeal outbreak is the most immediately danger- 
ous, and must receive due and simultaneous attention. 
So far as my experience goes, nitro-hydrochloric acid 
is the most potent and reliable specific remedy for 
diphtheria there is, and should I be obliged to depend 
upon any single agent alone, would prefer it to any 
other, but this is not necessary as it may readily be 
supplemented with other acids and remedies accord- 
ing to the special type, stage, intensity and complica- 
tions of the case under treatment. Thus, ordinarily, 
I give the dilute nitro-hydrochloric acid in doses of 
from ten to fifteen drops in a goblet of lemonade, 
consisting of one lemon in that quantity of water 
sweetened to taste, which may be sucked through a 
glass or other non-corrosive tube ad libitum, so as 
speedily as possible to introduce enough acid to 
neutralize the superalkalinity and destroy the septic 
matter of the blood, disinfect the throat, alimentary 
canal, and body, and restore the normal equilibrium 
of htematosis, circulation, nutrition, secretion, and 
health. In its passage through the mouth, fauces, 
oesophagus, and stomach, or gastro-intestinal canal, it 
acts as a direct germicide, solvent, disinfectant, de- 
purant, alterant, and resolvent, as well as antalkaline, 
refrigerant and tonic, locally and generally. In 
young children and adults without teeth, it may of 
course be taken directly, as it forms a very pleasant, 
attractive, and refreshing drink, though frequent 
small quantities are better than occasional large 
draughts, the frequency and quantity of the dose 
being proportioned to the age of the patient and 
intensity of the disease. This may often be sufficient 
of itself and especially with corresponding acidulous 



98 BASIC PATHOLOGY AND SPECLFIC TREATMENT OF 

regimen of fruits, juices, jellies, and other food, 
particularly sour butter-milk, specified elsewhere, to 
resolve the disease altogether. 

In the more adynamic varieties of diphtheria and 
cognate diseases, I give in addition, a mixture of 
muriates of iron and quinia, with muriatic acid in 
lemonade or sweetened water, but when the dispo- 
sition to faucial inflammation and exudation is strong, 
omit the quinine and add small quantities of potassium 
and sodium chlorate. Hence to supplement the 
nitromuriatic acid and better meet the special indi- 
cations to counteract the plastic exudation in the 
throat, degeneration of the blood, and tendency to 
adynamia and paralysis, with the general septic con- 
dition, I usually combine in prescription, tincture of 
chloride of iron, hydrochloric acid, potassium or 
sodium chlorate, or both together in small doses, with, 
in cases of active disposition to, or much depression, 
tonic doses of muriate of quinia, all in orange, plain, 
or better still, tar-water — infus. picis liq. as a men- 
struum and mild stimulant, disinfectant, depurant, 
and alterative. Thus, for an adult, in the ratio of 
from ten to twenty drops of the dilute muriatic acid, 
ten to fifteen minims of the tinct. of iron, two grs. of 
the potassium and three of the sodium chlorate, one 
gr. of the muriate of quinia, and a tablespoonful to 
an ounce or more of tar water according to its 
tolerance, in one dose, all of which may be given in, 
or be followed with a draught of lemonade, sweetened 
barley, or plain water, as often as may be necessary. 
The acid and chloride of iron act locally and generally 
as antalkaline, antizymotic, astringent, disinfectant, 
antiseptic, haematic, and tonic agents. The potassium 
is a solvent of the plastic exudate and resolvent of the 



DIPHTHERIA, TYPHOID, AND ALLIED} DISEASES. 99 

inflammatory disposition, though it should be care- 
fully given even in small doses, and subordinate to 
the acid treatment, as it will increase the superalka- 
linity, fluidity, and disorganization of the blood, and 
depress the action of the heart, circulation and system 
in general; hence, unless the exudative tendency is 
strong, it is better omitted altogether, and in all cases 
withdrawn so soon as the acute stage resolves, espe- 
cially as it may be substituted by the milder sodium 
chlorate, which is likewise solvent, but not depressing, 
though apparently too diaphoretic sometimes, so also 
to be watched and diminished or withdrawn as the 
exudative disposition and inflammatory condition 
subsides. In fact, the sodium salt is often preferable 
from the beginning in this and other diseases, where 
a solvent and resolvent effect is desirable, though they 
may sometimes be combined with advantage. 

This local inflammatory and exudative tendency in 
the pharyngeal region varies greatly, and according 
to its activity and non-complication with the consti- 
tutional dyscrasia or ammonamiia and septicemia of 
diphtheria, it approximates true croup and ordinary 
cynanche, or more purely local inflammatory affec- 
tions of the throat, which require the opposite 
alkaline treatment more exclusively, such as potas- 
sium and sodium chlorate, nitrate, citrate, etc., or 
when there is much irritation and spasmodic action 
alone or in conjunction therewith, better doubtless, the 
corresponding acid and salts of bromine, or hydro- 
bromic acid, bromides of sodium and potassium, as they 
exert a special amesthetic, relaxing, and resolving effect 
upon the fauces, yet, being in general, too depressing 
in diphtheria which requires a more exclusively sup- 
porting acid, antalkaline, and tonic treatment. 



100 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

Iodoform is also too depressing in diphtheria and 
its asthenic correlatives, but will doubtless afford 
more direct and speedy relief in croup, especially its 
spasmodic form, with other sthenic anginose affections, 
as it is a prompt and potent local, pharyngeal, and 
general anaesthetic, antispasmodic, and resolvent, as 
well as germicide, antiseptic, and sorbefacient. It 
usually soon allays irritation, relaxes spasm, annuls 
pain, and produces sleep. It relieves urethral, utero- 
vaginal, intestinal, and oesophageal spasm and 
stricture, checks vomiting and cough, resolves swell- 
ing, promotes absorption, and diminishes excitability 
of the nervous and general system, acting both 
directly and indirectly in discussing oral, pharyngeal, 
bronchial, and pulmonary affections, and quieting the 
neuroses connected therewith. Hence, it is specially 
indicated in croup, mumps, hiccough, whooping- 
couo-h, with like affections, and those still more 
formidable maladies — hydrophobia, cerebro-spinal 
meningitis, epilepsy, eclampsia and tetanus, with 
sthenic irritability, supersensibility, spasm, sensori- 
motor, phlegmonous, neurotic and psychotic affections 
generally. The dose should be proportioned to the 
emergency, but, ordinarily I find that one grain every 
hour or two hours, more or less frequently, is usually 
soon sufficient to overcome quite active disorder, even 
one pill alone of gr. j of iodoform, and 1J grs. of iron 
(Warner's), will often allay severe pain and neuralgia, 
of the face and head especially, and induce sound 
sleep, though followed sometimes by temporary 
languor, but permanent relief. If taken too freely, it 
will produce chilliness, gastro-intestinal disorder, 
diarrhoea, and depression, with other evidences of 
intoxication therefrom. 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 101 

Hydrarg, bichlorid, which has of late been so highly 
recommended as a disinfectant, germicide, and re- 
solvent in diphtheria and correlative diseases, is also 
more applicable to the sthenic inflammatory stage 
and type than the more purely asthenic condition of 
such anginose affections, and may be used when 
necessary in conjunction with its compatibles, espe- 
cially as a substitute for the alkalies when they are 
contraindicated, though I have never found it advis- 
able to resort to it therein. In a discussion upon this 
subject at the late meeting of the Illinois State Med, 
Society, Dr. E. P. Cook, of Mendota, a former Presi- 
dent of the Association, stated (Jour. Amer. Med, 
Assoc), "that he had a limited experience in the use 
of bi-chloride of mercury. His experience of its use 
was that in follicular pharyngitis the patients all got 
well, but in malignant diphtheria they died. In the 
latter form of the disease, seven out of a group of 
eight of his patients had died after treatment with 
bi-chloride of mercury." Prof. Pepper and others 
commend its efficacy in diphtheria, but, at best it is a 
dangerous remedy, and apparently applicable more in 
the croupous than the malignant form of diphtheria, 
wherein, however, the alkalies are safer and usually 
promptly resolvent, though in smaller doses the} 7 may 
be commingled where their combined effects are 
desired. 

Thus, diphtheria and croup with the more purely 
inflammatory forms of cynanche, differ widely in both 
their pathology and treatment, the former mainly 
requiring acids, the latter alkalies, though they often 
merge and blend with each other in every degree and 
variety, so as to need a mixed course of the neutral 
salts with acids or alkalies correspondingly, or the 



102 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

more exclusive acid or alkaline treatment as the 
pathological conditions of the one disease predominate 
over the other, while the extremes are so distinct as 
to necessitate the free exhibition of either accordingly, 
the acid, antiseptic, and tonic treatment being basic 
and essential in diphtheria. Usually, in the acute 
stage of this disease, quinine is not so strongly indi- 
cated, and should not be given therein unless the 
adynamic disposition is active from the beginning. 
Besides, it is useful only in small and tonic doses of a 
grain or less, large doses being sedative and injurious 
in all cases. Hence, as the acute inflammatory stage 
diminishes I withdraw the alkalies, or withhold them 
altogether when they are contraindicated ab initio, and 
add the quinine to the iron and hydrochloric acid, 
with in addition thereto muriate of strychnia in doses 
proportioned to the age and necessity, as from the 
thirtieth up to hundredths of a gr., to more fully 
counteract the tendency to the paralysis which is so 
apt to ensue more or less suddenly as the active 
excitement declines in diphtheria. The solvent tar 
water serves the double purpose of an efficient adjunct 
and menstruum, as it is a mild stimulant, antiseptic, 
alterative, secernant, diuretic, and tonic, as well as 
local disinfectant, depurant, and alterant to the 
mouth, throat, and gastro-intestinal canal, though it 
is not very pleasant to take, and may be substituted 
by more agreeable, less active, aromatic infusions, as 
of eucalyptus, orange, water, or other convenient 
menstruum. 

When a more decided diffusible stimulant is re- 
quired, instead of alcoholic liquors, the effects of 
which are evanescent and obnoxious, I exhibit the oil 
of turpentine, as it is a more useful remedy, being an 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 103 

active arterial and nervous stimulant, antizymotic, 
antiseptic, germicide, disinfectant, diuretic, diaphor- 
etic, alterative, resolvent, depurant, and restorative, 
and, from its volatility may be administered freely 
and steadily by inhalation without drugging the 
stomach, thus acting favorably directly and continu- 
ously upon the pharynx and air-passages, blood, 
secretions, and general system of both the patient 
and attendants, the vapor of turpentine serving to 
disinfect the air and bod}-, overcome the disease, sup- 
port and restore the patient, and protect those exposed 
to the infection. " Turpentine being a germicide 
even in so weak a solution as one part to seventy-five 
thousandths," according to Dr. R, F. Weir, surgeon 
to the New York Hospital.— (N. Y. Med. Jour.) 

Thymol is also an active volatile disinfectant and 
germicide, with the great advantages of having a 
pleasant odor and being non-irritant to the throat and 
air-passages. It may be exhibited singly or in con- 
junction with turpentine to disguise its offensive smell 
to many. 

A still more potent nervous stimulant is phosphoric 
acid, which is also antalkaline, antipyretic, refreshing, 
and corroborant, but not so disinfectant and antiseptic 
as hydrochloric and nitromuriatic acids. It may be 
given as an adjunct thereto, or. in conjunction with 
its salts of iron, quinia, and strychnia, as phosphates 
or lacto-phosphates thereof, be alternated or substi- 
tuted for the muriates of the same, especially in the 
latter stages and in convalescence, to counteract the 
scorbutic, superalkaline, and adynamic states of diph- 
theritic with cognate disorders — the paralytic particu- 
larly, re-invigorate the system, and restore the normal 
tonicity of health. Oxygen, peroxide of hydrogen, 



104 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

and nitrous oxide are also applicable as potent dis- 
infectants, antiseptics, haematics, revivifiers, depur- 
ants, stimulants, tonics, and restoratives, in this with 
correlative affections. 

In diphtheria, with all the zymotic, septic, scorbutic, 
mephitic, infectious, and allied diseases, the free 
administration of the mineral acids should be sup- 
plemented by the liberal use of the vegetal and 
animal acids ad saturandum, either in solution as 
lemonade, or preferably when the stomach is intole- 
rant of much fluid, in the concentrated juice of limes, 
lemons, oranges, grapes, and other acid fruit, with 
the jelly of cranberries, or other acidulous berries, and 
stewed apples, cherries, plums, prunes, and like edible 
sour vegetals, with as much sugar as desired, this 
being a valuable antiseptic, as well as corrigent, and 
and nutriment. Ripe, pulpy, juicy, acidulous fruit, 
as peaches, pears, plums, grapes, tamarinds, and the 
like, also afford both remedial food and medicine that 
may be taken more or less freely with advantage, 
laxative substances being in general, more essential in 
these diseases, though when otherwise, the astringeM 
acid remedies, fruit, and food may readily be sub- 
stituted. 

For the more concentrated and purely nitrogenized 
aliment sour buttermilk, and cottage cheese when 
tolerated, with like acid albuminoids, with sugar, are 
most appropriate, agreeable, highly nourishing and 
restorative, the lactic acid therein acting as a digestive, 
antalkaline, antiscorbutic, antiseptic, antiphlogistic, 
febrifuge, and hsematosic. It is a solvent of the 
membranous exudate, and depurant of the throat, 
stomach, and bowels, with the general system, thus 
acting beneficially both locally and constitutionally. 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 105 

This acid fluid and solid food is in general, most 
acceptable and digestible, and preferable to extracts 
of beef or other meat, as such aliment is not ordinarily 
fancied or easily digested in this and cognate diseases, 

rom lack of acid gastric juice. For the same reason, 
soused pig's feet, pickled tripe, acidulated oysters, 
eggs, caviare, and other albuminous food with vinegar 
or other acid, are most palatable and nourishing in 
such maladies, vinegar being also antalkaline, solvent, 
digestive, secernant, antiseptic, refrigerant, disinfect- 
ant, and depurant, useful both locally and generally, 
and may also be employed as a gargle and drink in 
these diseases. Peptonized food is also applicable 
when necessary, pepsin itself being an active solvent 
of the membranous exudate and may be exclusively 
employed therefor. Amylaceous aliment is usually 
undesirable and unnecessary, as it cannot readily be 
transformed, and its saccharine ultimate can be 
directly had sufficiently in both the cane and grape 
sugar with the acids and other food without taxing or 
clogging the stomach and bowels therewith. With 
these various articles the system can be supplied with 
an abundance of appropriate aliment, albuminous, 
saccharine, and acidulous, the most essential in such 
cases, in the most concentrated, easily digestible and 
assimilable form. 

Thus, in fact, in diphtheria and correlative diseases 
generally the digestive and nutritive processes are 
more or less seriously impaired, and it is not only 
useless, but injurious to overload the stomach and 

ystem with food it cannot transform and appropriate, 
under the false idea of supporting, when it is really 
taxing and depressing the vital energies, and in- 
creasing the complications and danger of the disease. 



106 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

Hence a judicious discrimination in the nature, 
quality, quantity, and condition of the food is all 
essential in this with all other diseases, as alimentation 
is the basis of medication in all cases, and the more 
exclusive acid aliment and remedies being most ap- 
plicable in diphtheria and cognate maladies. 

With this general acid and conjunct treatment no 
special local applications to the throat are required in 
diphtheria and its correlatives cynanche maligna, 
scarlatina, etc., though they may be employed to any 
extent indicated, particularly ice or cold externally as 
well as internally in the acute stage, as the acidulous 
remedies and regimen indicated act directly thereon 
and correct the gangrenous tendency, prevent the 
formation, and disintegrate, dissolve, and disinfect the 
fibro-plastic exudate, cleanse the pharynx, destroy the 
micrococci, fsetor, and contagion, neutralize the super- 
alkalinity, antisept and purify the blood and body, 
resolve the local and constitutional disorder, restore 
the balance of chemico-organic action, nutrition, 
secretion and defecation, invigorate the nervo-motor 
system, and re-establish the tonicity of health in 
general. 

Moreover, in diphtheria, and all the zymotic, septic, 
scorbutic, and putrescible diseases generally, there is 
more or less intense instinctive craving for acids and 
acidulous substances, which clearly indicates their 
necessity and use. Usually patients take them 
eagerly and freely until the superalkalinity of the 
blood is neutralized, the scorbutic, septicemic, in- 
flammatory, and febrile condition allayed, the equilib- 
rium of nutrition, secretion, and excretion restored, and 
the general system disinfected, depurated, and invigor- 
ated, the desire therefor proportionately diminishing 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 107 

till it ceases altogether and they become repugnant, 
so that ordinarily this instinctive appetite for acids 
is a sure guide to their use, though from false ideas, 
perverted tastes, and acquired habits, it cannot always 
be relied upon, the pathological and physiological 
conditions being the best indications to the physician 
for their administration or withdrawal. Some of 
these are prominently presented in the appearance of 
the blood, mucous membrane, and general surface, 
especially in the lips, mouth, tongue, and countenance. 
These with the hands more particularly show a more 
or less diffused or mottled redness of a brownish, 
dusky, purplish or venous and scorbutic hue, varying 
somewhat according to the type and intensity of the 
disease, which disappears as the ammon?emia and 
superalkalinity is neutralized, and the lips, tongue, 
and complexion assume a clearer, lighter, and 
healthier color. This is usually so decided that the 
observing physician can surprise his patient by telling 
him he is loosing his relish for acids and that they 
begin to taste too sour and be repugnant, in marked 
contrast with their previous agreeability, so that they 
need not be taken so freely and be gradually withdrawn 
as the disease subsides and the corresponding necessity 
for them diminishes, being continued in a modified form 
in conjunction with the acid muriates, phosphates, or 
lacto-phosphates of iron, quinia, and strychnia, in the 
adynamic states of diphtheria and' other diseases until 
the health is entirely restored. Chlorine vapor, 
chlorine water, and chlorinated soda, lime, sulphur, 
carbolic, sulpho-carbolic and other acids, with their 
analogues and combinations are also useful in diph- 
theria with septic diseases generally, but are not so 
safe, pleasant, easily or freely taken as the acids and 
compounds thereof designated. 



108 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

Thus, while microscopists find the same micrococci 
and fibro-plastic elements in the morbid condition and 
membranous exudate of the pharynx in diphtheria, 
croup, and other anginose affections, and see no 
essential difference between these local disorders of 
the throat, the physiological chemist and pathologist 
find in addition, the blood superalkaline or ammonia- 
cal, deteriorated, and toxemic, with an infectious 
principle, and a concomitant paralysis — mostly 
pharyngeal, though sometimes more general in the 
former, while the therapeutist putting all these to- 
gether, logically deduces the specific treatment 
thereof in accord with the laws of chemistry, physi- 
ology, pathology, hygiene, and scientific medicine 
generally. This consists as indicated in the removal 
of all the active and remote causes thereof so far as 
possible, with the free use of acids — mineral, vegetal, 
and animal, especially the hydrochloric and nitric 
acids or nitro-hydrochloric, with chlorine and the 
chlorides particularly of iron, quinia, and strychnia, 
and sometimes the chlorates of potassium and sodium, 
as potent antalkalies, disinfectants, antizymotics, 
antiseptics, alteratives, resolvents and tonics, with the 
more exciting, nervous and general stimulants and 
haemostatics, oil of turpentine, thymol, phosphoric 
acid, and phosphates or lacto-phosphates of iron, 
quinia, and strychnia, with oxygen, peroxide of hydro- 
gen and nitrous oxide, to counteract the adynamic 
and paralytic tendency and invigorate the general 
system, the acids, their elements and analogues being 
the essential basic and specific remedies to neutralize 
the ammoniacal or superalkaline and toxaemic con- 
dition, destroy the microzymes, disinfect, and depurate 
the throat, blood, and body, and restore the normal 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 109 

chemico-organic and dynamic balance of life, they 
being often of themselves sufficient, especially in the 
earlier stages of the disease to resolve it altogether, 
both in mankind and at least one, if not all the lower 
animals, as I had a favorite cat with the prominent 
symptoms of diphtheria that was promptly cured with 
sour milk I ordered her. 

With this general plan of treatment with the acids 
— mineral, vegetal, and animal, as a basis, both in 
medicine and aliment, I have always found this 
dangerous disease — diphtheria, to resolve more or 
less speedily, and the patients soon recover their usual 
health without ordinarily any complications or pro- 
longed convalescence. In fact, when seen in time, it 
may be thus aborted altogether, or rendered so mild 
as not to confine the patient to the house. In other 
malignant anginose affections and ulcerated sore 
throat, this acid treatment is also markedly efficient. 
Indeed, I believe that by proper sanitation and 
alimentation with the appropriate ingestion of acid 
juices, drinks, fruits, buttermilk, and other acidulated 
food as previously indicated, cceteris paribus, not only 
diphtheria, but all other zymotic, septic, infectious, 
necrsemic, scorbutic, putrescent and cognate diseases, 
could be largely prevented, as well as more or less 
promptly cured by the additional more active medica- 
tion with the stronger mineral acids and adjuvant 
resolvent, stimulant and tonic remedies. In fact, 
there is little doubt but what these diseases often 
occur in consequence of defective acid alimentation 
to neutralize the ammonia constantly evolved within 
the body in the normal chemico-organic processes, 
with that introduced from without the economy, and 
the frequent concomitant superalkalinity of the blood, 



110 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

which is the basis and primary cause of these scor- 
butic, septic, zymotic, toxemic, contagious and ady- 
namic maladies. Hence the best preventive thereof 
is the avoidance as far as possible of all their super- 
inducing causes, especially that most potent one 
tobacco in every form, with the due use of acid 
aliment, and remedies. Moreover, whenever or 
wherever diphtheria, or any of these, correlative, 
zymotic, septic, and contagious diseases occur, every 
one exposed thereto should be put on this acid 
regimen, and closely watched so that if any symptoms 
thereof appear the mineral and stronger acids with 
cognate antalkaline and other appropriate measures 
may be immediately resorted to. 

Confirmatory proof of the special value of acids in 
the treatment of diphtheria by the practical experience 
of physicians with the various forms thereof might be 
adduced, but I am not aware that they have ever been 
used as basic and specific remedies therefor in general 
by reason of their peculiar acid nature, much less 
upon the scientific principle of their efficacy as ant- 
alkalies, and particularly in neutralizing a common 
^etiological morbific alkaline factor of this, with all 
other zymotic, septic, contagious, mephitic, and allied 
diseases, with consequent abortion as well as direct 
extinction of their concomitant toxicoses and infec- 
tion, and all of which are dependent upon an excess 
of that ever-present volatile organic alkali — Ammonia, 
constantly engendered so freely within the living 
organism itself, as well as introduced from without in 
various forms of malarial and other noxious ingesta. 

Testimony is occasionally presented of the practical 
value of some one or another of the acids in the cure 
of diphtheria, and recently it is stated in the Scientific 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. HI 

American, by a California physician, Dr. Czartoryski, 
who lived long in the interior of China, that the 
Chinese freely take the fresh juice of limes with the 
fruit itself in diphtheria and consider it a specific 
therein as it hardly ever fails to effect a cure. In his 
own practice in Louisiana and California he has used 
limes and their juices with the greatest success even 
in the most desperate cases of diphtheria, wherein he 
orders " limes to be administered as freely as possible 
in any manner the patient can be prevailed to take 
them, especially in the form of hot lemonade, sweet- 
ened with white sugar or honey, or cut in slices with 
powdered white sugar." With lime juice, which he 
considers acts by affording an excess of oxygen to the 
blood, thereby preventing the development of vibri- 
ones, etc., he exhibits such drugs as may be indicated, 
with appropriate stimulants and nourishment to 
restore strength. Usually, however, cold lemonade, 
with acid water ice, or tart ice cream, ice, and iced 
drinks are most grateful and useful in the height of 
the disease, and hot acidulous drinks in the more 
asthenic conditions, although they may be given at 
any temperature according to the desire and mor- 
bid conditions of system. Lemon juice and other 
acidulous, with mucilaginous substances, as gum 
arabic, flax-seed, etc., have long been empirically 
popular in anginose affections. 

Thus, experience proves that vegetal, animal, and 
mineral acids act specifically in resolving diphtheria 
with all other superalkaline, zymotic, septic, scorbutic, 
and allied maladies. But, while such experience is 
valuable, it is more purely empirical and blind, and it 
is only when duly correlated with other facts in 
aetiology, pathology, hygiene, and therapeutics, that 



112 BASIC PATHOLOGY AND SPECIFIC TREATMENT OP 

scientific principles and a true theory can be established 
that directs to the most accurate and successful treat- 
ment from positive knowledge of all the essential 
data upon the subject. 

From the fact that this class of varied acid sub- 
stances with cognate disinfectant, antalkaline, neutral- 
izing, and resolving agents are so generally efficacious 
in scorbutic, zymotic, septic, iufectious, putrescent, 
and correlative diseases, it supports the view of their 
common origin and dependency upon a superalkaline 
condition of the blood and system, of which the most 
general and active morbific element of the kind both 
from inherent and extraneous sources, is the volatile 
organic alkali — Ammonia, the existence of which in 
excess has been to a certain extent directly demon- 
strated in such maladies. Furthermore, from the 
correlative facts that this same organic alkali — 
ammonia, is being constantly engendered de novo 
from its elements within the body in the normal 
chemico-organic transformations, and that it may be 
abnormally increased by various causes as excessive 
heat, bodily exertion, molecular and morbid metamor- 
phosis, with perverted disintegration and undue ac- 
cumulation from insufficient elimination, as well as be 
more or less freely introduced from without in 
malaria and contaminated water from decomposition 
of organic matter, and more excessively with other 
alkaline and noxious substances in such pernicious 
agents as the juice, vapor, and smoke of tobacco, 
with the so frequent defective counteractive acid 
alimentation, and other aberrant influences, in ad- 
dition to its potent volatile, permeating, solvent, 
irritant, and morbific power, it is not wonderful it 
should produce a general pathological state of the blood 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 113 

and body, and induce those disorganizing scorbutic, 
toxemic, necnemic, febrile, infectious, and mephitic 
conditions so often manifested in such a variety of 
constitutional and local dicases of a septic, contagious, 
and adynamic typo, intensified and modified accord- 
ing to casual cooperative meteorological, pestilential 
and other agencies that so seriously afflict and destroy 
mankind with the lower forms of life the world over. 
Nor is it singular that the same general acid and cor- 
relative neutralizing, antalkaline, and antagonizing 
Mis should act as basic and specific remedies in 
such a variety oi diseases from an identical, underly- 
ing alkaline cause and dyscrasia, with or without the 

addition of special adjunct- appropriate to the 
nihilities of each, according to their respective 
manifestations and complications. But, while there 
is thus such a close connection of these varied innocu- 
ous and malignant affections, both pathologically and 
clinically, there is a wide difference between a purely 
»n and a local manifestation or complication 
of a constitutional dyscrasia, though they are so often 
combined, and what commences as a benign local 
disorder may become from the additional superim- 
posed ammoniacal and superalkaline condition of the 
system, a most malignant, infectious, and fatal 
malady, as is bo frequently exemplified in the ordinary 
innocuous anginose affections becoming diphtheritic 
and contagious, as well as slight local lesions in 
different parts of the body becoming erysipelatous 
and malignant, with in like manner, all correlative 
maladies being intensified or assuming a virulent, 
contagious, and pestilential type. 

Thus, the common naso-pharyngeal affections, both 
acute and chronic, may assume a diphtheritic and 



114 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

infectious type from anything which surcharges the 
blood and system with an excess of ammonia, as well 
as the more direct. toxic emanations from others that 
would otherwise in its absence be comparatively 
innocuous, it being but a matter of degrees between 
the most benign and the most malignant anginose, as 
with all other diseases. Diphtheria and contagia may 
be thus developed and communicated whenever 
this superalkalinity of system and concurring circum- 
stances are favorable, which are doubtless more 
frequent than is generally suspected, as this am- 
moniacal condition of the blood and body may occur 
in every degree of intensity from the norme to a 
saturated morbific and pestiferous state. 

In an interesting paper upon " Diphtheria Spread 
by Adults," -read before the Medical Society of the 
County of New York (N. Y. Med. Journal), Dr. A. 
Jacobi presented facts to prove that there are a great 
number of cases of latent and chronic diphtheria in 
adults, which were regarded as but simple sore-throat, 
yet sufficiently contagious to disseminate the disease 
indefinitely among the people, by the patients being 
able to go about their usual business, and infecting 
many who came in contact with them, especially 
when they were in more or less immediate close 
relations therewith, as nurses, servants, and children, 
for as he forcibly observes, " There is as much diphtheria 
out of bed as in bed ; nearly as much out of doors as in 
doors. Many a mild case is walking the streets for 
weeks without caring or thinking that some of his 
victims have been wept over before he was quite well 
himself." 

Hence, it behooves every one to carefully cleanse, 
disinfect, and purify their mouths, throats, and air- 
passages, as well as blood and body generally, and 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 115 

avoid exposure to infection, with particularly, the 
predisposing and exciting causes thereof from all 
noxious agencies that produce sore-throat or angina 
and ammonaemia or a superalkaline state of the 
system, the most common and potent of which are the 
baneful fumes and smoke of tobacco, so recklessly 
diffused everywhere, which not only excite naso- 
pharyngeal, bronchial, pulmonary, and other local 
disorders, but, furthermore create a pernicious con- 
stitutional dyscrasia that engenders toxic and infec- 
tious principles, with malignant types of disease, and 
intensify pre-existing abnormities — both local and 
general, thus often converting an innocuous affection 
into a virulent and contagious malady, as well as 
developing de novo pestiferous forms of disease that 
may be extended indefinitely. 

Thus, the common pharyngeal affection in croup, 
quinsy, or ordinary sore-throat and cynanche gene- 
rally, and so dangerous from its locality, though 
intrinsically benign within itself, is dependent more 
or less directly upon some local irritant or noxious 
vapor, and the same general meteorological cause of 
dampness and cold, or change of temperature, ex- 
posure, and other like causes, but while the local 
disorder may be similar, how different is the essential 
character, complications, danger, and treatment, of 
such abnormities when there is an existing ammon- 
semia, superalkaline or scorbutic condition of the 
blood, which renders both the local complaint and 
systemic derangement of a more or less virulent 
and infectious nature, as in diphtheria, cynanche 
maligna, and scarlatina, with erysipelas, and other 
local expressions or complications of a constitutional 
dyscrasia in different parts of the body, and which 



116 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

require the same basic and specific acid or antalkaline 
treatment, so opposite and distinct from the former, 
to subvert and counteract the underlying superalka- 
linity and toxaemia, abort and destroy the contagia, 
and resolve the local lesion with the systemic malady. 
This is remarkably exemplified in erysipelas, 
which may occur in any part of the economy from 
various traumatic and other agencies, or idiopathi- 
cally, apparently from the intensity of the arnmon- 
semia, concomitant blood poison, and systemic 
dyscrasia, without any immediate perceptible exciting 
cause, but, notwithstanding its multiple local mani- 
festations, may be usually successfully treated upon 
the same general principles applicable to diphtheria 
and its congeners, with the mineral, animal, and 
vegetal acids, the muriatic or nitromuriatic espe- 
cially, muriated tincture of iron, quinia, and tar 
water, with the acid regimen, and appropriate local 
applications, though sometimes the salts of potassium 
and sodium chlorate, may be conjoined in moderation, 
when it is of a more active phlegmonous and exudative 
character, yet are inadmissible in the more purely 
gangrenous variety in which the acid and tonic 
treatment is exclusively required. The sesquichloride 
or muriate of iron particularly, has obtained a well 
deserved repute in the cure of erysipelas, but it is 
probable that its efficiency is due more to its chlorine 
and acid than the iron, though the latter is doubtless 
also remedial therein, as erysipelas frequently occurs 
in plethoric persons whose blood is not apparently 
deficient in iron, but ammonsemic, toxemic, corrupt, 
and loaded with noxious and excrementitious matters, 
which chlorine, acids, and other antalkalies, dis- 
infectants, and antiseptics, neutralize, destroy and 



DIPHTHERIA, TYPHOID, AND ALL! 117 

eliminate. The m acids alone are often ent 

to relieve and prevent this d: amplified in 

and spirit drinks ect 

thereto, and by whom the lactic, citric, and ot 

in the form of sour buttermilk, sauer kraut, 
lemonade, and acidulous fruits and food g ly are 

,uently empirically r> rted to advantageov 

satisfv th e craving for acid and antalka- 

- 

line 

The same instill :or acids is 1: le mani- 

I >bacco isomers to neutralize the aj 
ficially indu .peralkalinity of the blood and - 

tern, from the ing ated ammonia, nicotia, and its other 
baneful ingredi . with al- normal thirst for 

stumulants to overcome the c —ion from this 
noxious poison, hence the use of tobacco and spirit- 
uous liquors usually g g ::ier, acting and :ng 

:i each other, both d : . and ind: 

morbid a] with de I conditions of b 

and mind, and debase, d nd d man- 

kind. Ii. : . ~ raving for i is thus so i re- 

dominant in individual consul tobacco and 

alcoholic liquors, and is so general, as to become a 
: national iliarity in people addicted or 

reto, as ind in the following remarks 

on " Tobacco and Pi in the Dr< cular: 

•• The Dutchman of to-d s gi :it a smoker as 

ther. The pipe has, how- 
. ;nd the meanest lab<: 
indulges himself, often when at work, with th e ' 

which sts him less ::ian a farthing 

The teetL fi Dutchman is n; 

the skin of an Englishman who ha- a lon^ 

time in Indi. much discolored, and many : 



118 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

the incisors are carious. The Odontological Society 
will find the best specimens of discolored teeth from 
smoking among modern Dutchmen. The Dutchman's 
partially for pickles is peculiar, yet easily explained. 
In Rotterdam, but more largely in Amsterdam, pickle- 
stalls are not much less frequent than apple-stalls in 
London. The pickle-stalls seems to be, with many 
workmen, the half-way house between the work-shop 
and the dining-room. This nation of confirmed 
smokers abounds in dyspeptics; and the poorer classes 
give their clammed palates a filip occasionally with 
the sour and acid substances sold in the streets." 

Gastric troubles, however, are not the only local dis- 
orders from tobacco, as it also, as before stated, causes 
diseases of the mouth, throat, nares, air-passages, lungs, 
heart, liver, kidneys, and other important organs, with 
the general state of superalkalinity, toxaemia, and 
adynamia, for the relief of which the instinctive 
craving for acids and stimulants or tonics indicate 
the basic and predominant means of cure, similar in 
general to that required in erysipelas and allied 
dangerous manifestations of a like constitutional 
dyscrasia, with of course the removal of the cause 
as well as treatment of the effects. 

Moreover, in a similar internal local expression of 
a general dyscrasia from ammonsemia and its con- 
comitants, which is engendered more particularly by 
the prolonged physiological function of gestation, as 
well as excited by parturition, although the former is 
usually the remote cause of the superalkalinity and 
toxaemia and the latter the immediate excitor of 
metro-peritonitis and septicaemia or puerperal fever, 
the same basic and specific acid and collateral treat- 
ment is best adapted, and will promptly relieve ac- 
cording to my experience. Thus, for example, in the 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 119 

case of a primipara, from whom, after ineffectual 
efforts to deliver herself even with the aid of ergot, I 
had to remove the child with the forceps while she was 
under the influence of ether, and resuscitate it after 
much effort, I found on attempting to extract the 
placenta that it was retained, and on examination dis- 
covered an hour-glass contraction of uterus, which 
I overcame by gentle and steady pressure with my 
folded fingers, enough to reach and carefully remove 
the secundines from the fundus. Metro-peritonitis, 
scanty lochia, with an ominous cadaverous odor, 
general sinking, and febrile symptoms, with other 
evidences of septicaemia and puerperal fever soon en- 
sued, but by the acid treatment as a basis, of nitro 
and hydrochloric acids, sesquiehloride of iron, potas- 
sium and sodium chlorate, and quinia in tar water, 
with active stimulation by the oil of turpentine 
alone, locally and generally, without alcoholic liquors 
of any kind, and appropriate aliment, she so speedily 
and perfectly recovered, that in less than two weeks, 
contrary to my most earnest advice, she took her 
babe and went out to the Centennial, several miles 
distant, it being the last day of the Exhibition, de- 
termined to be able to say that she and her child had 
been there, which visit, though necessarily attended 
with considerable risk and fatigue, fortunately did not 
result in any mishap. 

As spirituous liquors promote the development of 
such ammoniacal, toxemic, erysipelatous, and phleg- 
monous conditions manifested in puerperal metritis, 
septicaemia, fever, and allied affections — local and 
general, they are contraindicated therein, while the 
acids and their cognate elements and salines, with the 
oil of turpentine, quinia, and other antalkalies, disin- 
fectants, resolvents, stimulants, and tonics, according 



120 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

to the special type, stage, complication, and depress- 
ion, are most applicable and useful to neutralize the 
superalkalinity, destroy, nullify, and eliminate the 
poisons, discuss the disease, and restore the vigor of 
health. 

Alcohol promotes the inception of, and is opposed 
to resolution and recovery in puerperal fever with all 
allied affections, as it deoxidizes and asphyxiates every 
blood-corpuscle, molecule, and part of the system, and 
induces a state of toxaemia both directly and indirectly, 
with a scorbutic, septicaeinic, an d erysipelatous cachexia, 
hence is doubly injurious therein. Much evidence 
might be presented in proof thereof. Thus, for in- 
stance, in an interesting article on the a Toxic Effect 
of Alcohol in Exsanguinity," (Jour. Amer. Med. Assoc, 
March 8, 1884,) Dr. Joseph Sager pertinently observes 
in this connection : 

"Alcoholic toxaemia will produce a constitutional 
tendency to inflammation. This we notice in de- 
bauchees. While in this debauched condition from 
alcohol, the least lesion tends to inflammation. The 
worst case of cellulitis I have had, was a case of this 
kind." 

" In my early practice I remember a physician who 
invariably ' dosed 'his puerperal patients with whisky. 
This physician had more puerperal fevers to contend 
with than any other physician in his vicinity. He 
finally sacrificed his own wife to this sinful practice." 

" I know of a bleeder, who whenever she would take 
wine, the haemorrhage was increased. She finally re- 
fused to take it at all. I gave her credit for her good 



sense." 



Alcohol not only promotes ammonaemia, congestion, 
haemorrhage, and inflammation, but also lithaemia, sep- 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 121 

ticaemia, pyaemia, uraemia, anasarcous, albuminuric, 
and correlative abnormities with their destructive 
concomitants — both systemic and local, in fact, it 
variously enervates and disorders body and mind, 
hence it is especially pernicious and objectionable in 
the pregnant and puerperal state with all cognate con- 
ditions tending to a superalkaline and toxic, as well as 
in a pre-existing morbid and malignant state of system. 
Conversely, the acid regimen is adverse to such 
abnormities, and is very appropriate during the whole 
period of gestation as a rule, to prevent ammonaemia, 
uraemia, and their concomitants, with the terrible 
puerperal eclampsia as well as fever so apt to ensue 
from pregnancy and parturition, though it is probable 
they depend to some extent upon urate of am- 
monia and concomitant toxic agents, rather than the 
more simple uraemia, as urea is an active diuretic and 
hence not easily retained in the body without renal 
obstruction, while both ammonia and uric acid are 
more freely formed and kept therein from defective 
oxidation and elimination in such conditions of the 
system. But, as the acids promote oxidation, di- 
minish the production, increase the final evolution 
and expulsion of such excreta, they are strongly in- 
dicated in the gestative and parturient periods as well 
as in general, to subvert such dangerous tendencies 
and sequelae. Hence, a judicious use of lemon, lime, 
and other acid juices, jellies, fruits, and the more 
nutritious articles of the acid regimen, sour butter- 
milk especially, as fancied and required, will directly 
counteract the basic causes of sickness of the stomach, 
and other disorders of pregnancy, with puerperal 
eclampsia and fever, as they subvert the ammoniacal 



122 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

dyscrasia, neutralize the superalkalinity of, and de- 
purate the blood and body, promote the normal secre- 
tion and action of the stomach, liver, bowels and 
kidneys, with nutrition and the healthy functions of 
life generally, refresh and invigorate the system, and 
proportionably favor gestation and parturition, with 
the general physiological processes of restitution. 

As thus indicated, the excessive production and 
accumulation of ammonia, uric acid, and their con- 
geners in the body is both a cause and consequence 
of defective oxygenation, nutrition, albuminuria, and 
disordered action of the kidneys, with Bright's disease, 
as well as numerous other local and general abnormi- 
ties, especially when other emunctories, as the lungs 
and skin are unable to excrete them sufficiently. 
"Ammonia has long been recognized as an exhalation 
from the human body in health, from the skin as well as 

the lungs Reuling has shown that the 

quantity of ammonia in the expired air is increased in 
certain diseases, particularly in uraemia. Its characters 
in the expired air are frequently so marked that 
patients who are entirely unacquainted with the 
pathology of uraemia sometimes recognize the am- 
moniacal odor in their own breath." {Flint's Physiology.) 
Thus not only by the superabundance, but active excre- 
tion of ammonia and its congeners through the kidneys, 
lungs, and skin, renal, pulmonary and cutaneous, with 
other diseases are originated. Besides congestion of, 
and haemorrhage from, with other diseases of the kid- 
neys, lungs, and skin, they are thus doubtless more or 
less active in the production of that intractable variety 
of eczematous disease which require and often yield to 
the basic acid and antalkaline treatment, especially 
with iron and other constructive and restorative agents. 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 123 

Furthermore, in the minor though often severe and 
dangerous local affections of anthrax or charbon, 
malignant pustule, and carbunculoid affections, with 
gangrenous and sloughing wounds and ulcers, pur- 
ulent, scorbutic, and mephitic manifestations generally, 
likewise so largely dependent upon ammonaemia and 
concomitant toxaemia, the mineral, animal, and vegetal 
acids are of supreme importance as basic and constitu- 
tional remedies as well as general resolvents of the local 
disorder. These local affections with the more general 
systemic maladies being often a result of defective 
alimentation and sanitation, from insufficient acid diet, 
impure air and malaria, tobacco, alcohol, bad hygiene, 
overcrowding, overwork, and undue heat, as well as 
injuries, or traumatic, toxic, and other causes, the 
immediate ill effects of which in causing this ara- 
monaemia or superalkalinity of the blood with toxaemia, 
necraemia, septicaemia, and often sudden death, is seen 
in close confinement in hot places particularly, and 
from sun and heat stroke, as well as in ill-fed, over- 
exerted and over-driven men and cattle which 
frequently die so suddenly and decompose so rapidly. 
A notable instance of the rapid spontaneous develop- 
ment of this ammousemia, putrid crasis, septicaemia, 
and contagious fever is presented in the case of the 
survivors of the notorious Black Hole, of Calcutta, 
who were immediately seized with a malignant 
typhus fever from their short imprisonment and 
inhalation of poisonous exhalations from their com- 
panions in misery, with the noxious matter engendered 
in their own bodies. 

The same general pathological condition of the 
blood from the excessive evolution of ammonia in the 
body as well as introduction therein from without, 



124 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

and special local tendency to the liver with other 
organs, is largely induced by excessive heat, especially 
in hot weather, seasons, and climates, with the conse- 
quent production of hepatic and other disorders as 
inflammation and abscess of the liver, and such fevers 
as bilious, remittent, congestive, as well as the more 
profound typhus and ship, and doubtless also that 
formidable one of tropical climes — yellow fever, as it 
has been shown that in common with the others, it is 
largely dependent upon an ammoniacal and super- 
alkaline condition of the blood, ammonia being the 
most probable alkaline morbific agent therein, as it is 
so freely spontaneously engendered by heat and 
organic transformation, or decomposition within as 
well as without the living organism, though the same 
general superalkaline, scorbutic, and toxic condition 
may also be engendered in cold climates, and in fact, 
at any time, anywhere. Heat alone, but with 
moisture, so commonly combined in warm climates 
and places, being still more active in the production 
of such maladies as bilious, ship, typhus, congestive, 
yellow, and other malignant fevers, with the other 
pestilential diseases and plagues that so often and 
largely destroy both human beings and the inferior 
animals in hot seasons and climes. Thus the heat 
excessively increasing the development of ammonia in 
the vital economy, while the moisture in the air 
prevents its escape with other effete matter from the 
system, besides its free production outside the body 
in the decomposition of organic substances and intro- 
duction therein from the same causes, thereby doubly 
charging the blood and body with an excess of 
ammonia and other noxious matter, and inducing a 
superalkaline, toxsemic, and febrile state thereof with 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 125 

often local inflammatory and gangrenous lesions. 
Ammonia concentrated or in excess, being irritant 
and corrosive, and having a special tendency to excite 
inflammatory, febrile, and disorganizing conditions of 
the blood, tissues, organs, and system in general, 
which is intensified by external heat, malaria, defective 
alimentation and sanitation, bad habits and modes of 
living, tobacco miasm, alcoholic liquors, and other 
noxious agencies, is thus a potent cause of the most 
malignant zymotic, septic, necrcemic, infectious and 
putrescent maladies, as well as the less virulent 
scorbutic, mephitic, phlegmonous and gangrenous 
diseases. In a minor degree, this ammoniacal and 
toxic condition of blood and system is manifested 
in, and experienced by, every one, in the oppression, 
languor, prostration, and feverish feeling in close, 
warm, moist weather, for the relief of which the 
milder acids and acid regimen is so efficient, but in 
the more intense febrile states as common, bilious, 
remittent, tj'phus, ship, and other fevers, the stronger 
mineral acids are required, and as the acid treatment 
is so effective in these it will doubtless also prove as 
efficacious in j^ellow fever. 

The value of acid medication in this formidable 
disease has recently been shown by the successful use 
of phenic and sulphurous acid in yellow fever, as it is 
stated in the Med. and Surg. Reporter, that Dr. 
De Lacaille, of Rio Janeiro, "professes to have cured 
thirty-eight consecutive cases of yellow fever by the 
use of Deelat's preparation of phenic acid, sulpho- 
phenic acids, and in grave cases the phenate of am- 
monium. In the early stages the hyperdermic 
method is necessary. He contrasts very favorably 
his recent experience with his former sad failures 
without these drugs." 






126 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

But as the body is already charged with ammonia 
in yellow fever, the greatest success' would doubtless 
result in the treatment thereof as in allied diseases, 
by omitting it and its compounds, and exhibiting the 
mineral, animal, and vegetal acids more exclusively, 
with corresponding regimen as elsewhere indicated, 
with ol. terebinth, and like disinfectant, febrifuge, 
alterative, stimulant, and corroborant measures, 
according to the special indications in the varied 
states and complications of the disease. 

Besides the strong mineral acids with the vegetal 
acid fruit juices, some of which as lime and lemon 
juice are sometimes difficult to get in the colder 
climates, and more secluded places in times of 
emergency, there is the concentrated citric, acetic, 
lactic, tartaric, and other vegetal acids in various 
forms and solutions, more or less specifically useful 
in all such heated scorbutic, febrile, septic, infectious, 
putrescent, and mephitic conditions of system, from 
the most benign to the most malignant, prominent 
among which is the common compound of acetic acid 
in the form of vinegar. 

Vinegar is an active antalkaline, digestive, refriger- 
ant, febrifuge, styptic, antizymotic, resolvent, disin- 
fectant, depurant, secernant, diaphoretic, and diuretic. 
As a condiment with food it is in common use 
advantageously, and in water duly sweetened, it forms 
a very agreeable, refreshing, cooling drink, and has 
long been so used as a beverage in heated states of 
the system as well as in disease, and will doubtless 
prove as valuable in yellow fever as in all other 
diseases of the same general character, both internally 
and applied to the surface. "It displays decided 
soothing and refreshing properties, and is employed 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 127 

with advantage in inflammatory and bilious fevers, 
quenching the thirst, calming the vascular excite- 
ment, re-establishing the perspiratory function of the 
skin, and restoring the action of the kidneys. . . . 
It proves a direct antidote in poisoning by the alkalies. 
In these cases it is a safe and efficient remedy." — 
( Waring' s Practical Therapeutics). 

From its usefulness in putrescent and infectious 
diseases, vinegar disguised or aromatized, has been 
covertly applied by robbers to protect themselves in 
epidemics while pursuing their nefarious business, as 
in the plagues of Southern Europe and the East, 
hence has gained an empirical celebrity and designa- 
tion as " Thieves' Vinegar," and, though greatly 
overrated as a protective agent by ordinary inhalation 
in such cases, yet when freely vaporized and inhaled, 
or directly applied to the throat and surface of the 
body, is quite useful in gangrenous affections of the 
nose, mouth, pharynx, air-passages, lungs, and septic 
conditions of system, as in diphtheria, cynanche, 
scarlatina, putrescent fevers and affections generally. 
Taken internally, properly diluted and sweetened, it 
is of much practical value as an antalkaline, anti- 
pyretic, antiseptic, disinfectant, and restorative, 
though as Dr. A. T. Thompson observes, " In its 
undiluted state, it is a powerful stimulant," (irritant?) 
" and when daily taken in large doses, in its diluted 
form, it produces great uneasiness, cramps, and colics, 
and gradually destroys so effectually the texture of 
the stomach, and its digestive functions, as to cause 
emaciation of the body." — (Ibid.) 

The undue use of vinegar will even cause consump- 
tion, but in malignant fevers with infectious, putres- 
cent and scorbutic diseases generally, its free use 



128 BASIC PATHOLOGY AND SPECIFIC TREATMENT OP 

internally and externally, until these are overcome, 
will be corrective and beneficial, although it should 
not be employed to the exclusion of the more potent 
acid and other remedies therefor, but rather in their 
absence or in conjunction therewith. The old and 
well-known mixture of vinegar, molasses, and water, 
forms a very refreshing antalkaline, antiseptic, and 
antipyretic drink, useful not only in ordinary heated 
conditions of system, but also in the malignant 
fevers, and allied affections, and may often be resorted 
to with advantage when the finer and stronger acids 
are not at hand. 

The acid treatment with the mineral and vegetal 
acids, especially the hydrochloric, nitro-hydrochloric, 
phosphoric and citric, with the *other mineral and 
vegetal acids, and acid vegetal, and animal regimen 
previously indicated, is also applicable and will no 
doubt prove as basic and specific in the prophylaxis 
and treatment of yellow fever as in the correlative 
maladies of ship, typhus, remittent, and other malig- 
nant fevers, with small-pox, scarlatina, diphtheria, 
and other zymotic, septic, contagious, mephitic, and 
adynamic diseases. Fortunately in general, these 
mineral and vegetal acids can be readily obtained, 
though when some of the latter are not to be had in 
the fresh state as lime and lemon juice, etc., in times 
of emergency on ships at sea, and elsewhere, they 
may be substituted by their basic Citric acid, and as 
this is so efficient in the prevention and cure of scurvy, 
scorbutic, and septic diseases in general, it will doubt- 
less prove as specifically useful in yellow fever. 

" Lemon juice owes its efficacy to Citric Acid. . . . 
Dr. Bence Jones finds that an ounce of Lemon juice 
contains from twenty-seven to twenty-eight grains of 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 129 

anhydrous Citric acid, and about three-quarters of a 
grain of Potash, equivalent to two grains of Citrate of 
Potash." His experiments with the juice " show that 
its action on the animal system is in all respects 
identical with that of free Citric acid and entirely 
distinct from that of a neutral Potash salt. ' For all 
practical purposes/ concludes Dr. B. Jones, i we may 
regard Lemon juice as a free solution of Citric acid/ 
Lemon juice from which the free acid has been 
removed by Lime, is of no use in Scurvy at all." 

" Citric acid, given alone, is an admirable Antiscorbutic. 
Dr. Trotter long ago stated that he had experienced 
the power of this acid to be equal to any effect he had 
ever observed from the recent fruit in its most perfect 
state. And of the juice of the fruit he records that it 
was found ' a most infallible remedy/ both in the 
prevention and cure of Scurvy. The advantage at- 
tending the use of this acid in sea voyages is recorded 
by Sir Gilbert Blane and Dr. Bryson. Dr. Mc Wil- 
liam, who has had a large experience of its use 
assured me that he had found the simple Citric acid 
an admirable remedy in Sea-scurvy. Dr. Ritchie 
gives sometimes Citric acid, sometimes Lemon juice, 
and finds them equally serviceable. ... So that 
the positive experience of these and other physicians 
is in direct confirmation of the probability already 
established, that Lemon juice owes its remedial 
efficacy to this acid." — Headland/ (Action of Medicines.) 

In fact the experience of physicians everywhere is 
to the effect that Lemon juice and Citric acid are 
specifics for scurvy and scorbutic affections generally, 
and that the latter is the active principle of the 
former, though sharper, and perhaps not quite so 

G 



130 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

pleasant and lenitive, hence the juice with the mucil- 
age of the pulp of the fruit is usually most acceptable 
and will admit of freer use, as well as supply a larger 
modicum of nutriment especially grateful and useful 
when combined with sugar. 

Citric Acid is antalkaline, antiscorbutic, antiseptic, 
germicidic, antperiodic, refrigerant, febrifuge, dia- 
phoretic, diuretic, secernant, digestive, depurant, 
laxative, and restorative, though in large doses 
sedative and depressing. Property diluted and 
sweetened, " Citric acid constitutes a most service- 
able and agreeable beverage in fevers, and in those of a 
typhoid character. This is rendered more grateful and 
refreshing by using water impregnated with carbonic 
acid gas. In the ordinary condition of the stomach, 
Citric Acid, either pure or combined, does not weaken 
the stomach; and in some irritable states of that organ, 
characterized by a sensation of heat, painful diges- 
tion, an unpleasant taste in the mouth, and a disgust 
for food, it removes these symptoms, and proves de- 
cidedly beneficial ; but, on the other hand, when the 
stomach is highly irritable, and its nervous suscepti- 
bility great, Lemon juice or Citric Acid, even when 
largely diluted, cause heat, uneasiness, pain, and not 
unfrequently obstinate vomiting. Nevertheless as 
Mr. Broussais has remarked, the Citric is that acid 
which the stomach supports the best when suffering 
from inflammation.' 5 — [Waring' s Pract. Therapeutics.) 

Some of this gastric disorder and intolerance, is 
caused by the large quantity of fluid with the Citric 
acid, and its uncombined state, which may be avoided 
by giving it in sweetened gum arabic or barley water, 
and by letting the patient suck or sip the juice of 
limes, lemons, or oranges with as much sugar as they 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 131 

desire, or they may be incorporated together as a con- 
fection and taken at pleasure. Citric acid or lemon 
juice is especially useful in inflammations, fevers, 
scorbutic, septic, infectious, dyspeptic, hepatic, costive, 
anuric, and dropsical affections. It is particularly 
active in quenching thirst, reducing heat, and arterial 
excitement. "Dr. Owen Rees found that Lemon 
juice in doses of §j thrice daily, caused a great de- 
pression of the heart's action, in one case it fell from 
120 to 75 ; in another from 110 to 74; the pulse at the 
same time being rendered smaller. These effects 
were observed in patients suffering from acute Rheu- 
matism, but the same effect was observed in the healthy 
body; thus, a clinical clerk took f§j of Lemon juice 
thrice daily for three days, and carefully noted his 
pulse, which was naturally full, and about 75 in the 
minute. After five doses the pulse became much 
weaker, was more compressible, and numbered 70 in 
the minute. On the third day the pulse became as 
low as 66, and was very small and compressible. The 
urine was always acid, and also natural in quantity, 
till the third day, when it increased somewhat; the 
Sp. Gr. was then 1.017, and there was a deficiency of 
Lithic Acid. As an antidote to acro-narcotic poisons, 
Lime or Lemon juice is often very effectual. Its modus 
operandi is obscure, but its effects are often very re- 
markable. In overdoses of Croton seeds (Croton 
Tiglium), I have witnessed almost immediate cessa- 
tion of the vomiting, purging, and pain, from a single 
draught of lime juice." — (Ibid.) 

In the sickness of stomach, superalkalinity of blood, 
toxaemia, biliousness, thirst, constipation, and other 
disorders from that potent acro-narcotic poison — 
tobacco, Lemon juice or lemonade with other acids 



132 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

also afford relief, doubtless by neutralizing the inhaled 
alkalies and promoting secretion with the elimination 
of the poison from the body. This was practically 
discovered by the gentleman mentioned as so sus- 
ceptible to the noxious effects of tobacco, who finds 
that lemonade and the acid regimen afford more direct 
relief than anything else, though anodynes are re- 
quired to relieve the concomitant neuralgia therefrom, 
with general abstemiousness from much food until the 
stomach and system recover their normal tone. Citric 
acid and lemon juice are also useful in sickness of 
stomach from pregnancy, and in nausea and vomiting 
from other causes, especially when dependent upon 
ammonsemia with its concomitant toxaemia, and mal- 
arial or scorbutic conditions of system, hence is 
strongly indicated in yellow fever, both to prevent 
and correct the emesis so frequent therein, as well as 
for its general antalkaline, febrifuge, antiseptic, resol- 
vent, secernant, diaphoretic, diuretic, depurant, re- 
storative, and other remedial effects required in this 
pernicious disease with others of a like character. 
Thus in all sthenic fevers, the juice of limes and 
lemons, or citric acid in the form of lemonade, con- 
centrated and cold or iced, may be given as freely as 
the stomach will bear, while in the asthenic form, non- 
febrile, scorbutic and adynamic states, hot lemonade is 
often preferable, with other adjuvant acid remedial 
agents as indicated. 

Lemon juice or its analogues may often be advan- 
tageously combined with coffee or other corroborant, 
whenever a refrigerant stimulant tonic is required. 
Lemon juice in coffee is very efficient as an anti- 
periodic, antalkaline, alterative, and restorative in 
chronic paludal affections especially, as well as the 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 133 

more acute malarial disorders, the latter itself being 
also a potent antiperiodic, and tonic. I have found 
this combination very effective in breaking up chronic 
intermittents, exhibited in the strength of the juice of 
a medium-sized lemon to a cup-full of strong coffee 
sweetened to taste, as often as required. This will 
sometimes succeed when quinia and the usual anti- 
periodics and tonics have failed, though it may be em- 
ployed in conjunction therewith, according to the 
special indications. It is especially applicable as a 
preventive as well as cure of malarial diseases. 

In a paper read at the last International Medical 
Congress, in Copenhagan, Prof. Conrad Tommasi 
Crudelli, of Rome, thus testified to the value of lemon 
juice in malarial diseases [Medical Record): "It is 
well known that in Italy, Greece, and North Africa, 
that they often use lemon juice or a decoction of 
lemon seeds, as a remedy in malarial fevers of moder- 
ate intensity; and in Gaudaloupe they use for the 
same purpose a decoction of the bark of the roots of 
the lemon tree. All these popular practices tend to 
show that the lemon tree produces a febrifuge sub- 
stance, which resides in all parts of the plant, but 
which would seem to be most abundant in the fruit. 
In fact, among the popular remedies employed against 
malarial infection, that which I have just described is 
the most efficacious for it can be employed with good 
effects in acute fevers. But it is especially advanta- 
geous in combating the chronic infection, which is so 
rebellious to the action of quinine, and in removing 
or moderating its deplorable effects." 

Moreover, according to Dr. Schulz, France, [Boston 
Jour, of Chemistry), Citric acid is a potent antiseptic 



134 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

and germicide. He " found that one drop of a solu- 
tion of one part of acid to one thousand of water 
placed in a liquid containing bacteria and other 
organisms instantly caused their death as observed 
under the microscope." Besides, he " found a five 
per cent, solution of the acid to prevent meat from 
decomposing." 

Ihrtaric Acid, with which citric acid is sometimes 
adulterated, is also useful to a limited extent as an 
antalkaline, febrifuge, laxative, etc., and may be used 
in small doses for the same purpose, largely diluted in 
water sweetened to taste, as a cooling, refreshing, re- 
solvent drink in yellow, as in other febrile, inflamma- 
tory, heated, septic, and scorbutic states of system. 
But it should always be exhibited with care, and 
rather in the absence of better remedies, for " although 
cheaper and consequently more used than Citric Acid, 
it is inferior to it in many respects, being more apt to 
disorder the digestive organs, to produce colic, and to 
purge. In large doses it acts as an irritant poison. 
One ounce dissolved in half a pint of water caused 
violent inflammation of the alimentary canal and 
death in nine days. When its employment in medi- 
cinal doses, is followed by a red and dry tongue, 
it ought to be discontinued — (Dr. Thompson). It is 
said to be the best artificial solvent of mucus, and 
may be advantageously given when this exists largely 
in the bowels." — (Waring's Pract. Thera.) 

Lactic Acid, is also another organic acid, of both 
animal and vegetal origin. It is especially useful as 
antalkaline, digestive, antiseptic, antizymotic, febri- 
fuge, resolvent, depurant, and restorative, applicable 
in the prevention and treatment of diphtheria, typhoid, 
yellow and other fevers, with cognate zymotic, septic, 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 135 

contagious, scorbutic, and mepliitic diseases. In 
fact, as it is constantly engendered in the system, it 
may be partly from its deficiency at times that am- 
monaemia or superalkalinity of the blood with lithoemia, 
toxaemia, and their febrile and other morbid concomit- 
ants often ensue, though when in excess, it may excite 
inflammatory or other disease, as rheumatism, cardiac, 
and arthritic disorders for instance. 

In this connection Dr. Headland says (Action of 
Medicines): "It has long been considered probable, 
but may now be said to have been proven by the re- 
searches of M. Becquerel, that in febrile disorders and 
in inflammations there is excreted in the urine an 
excess of Urea and Urate of Ammonia, substances 
which are formed by the oxidation of the Nitrogenous 
tissues. This extra-oxidation probably arises from a 
deficiency of that matter which is the proper food of 
oxygen in the system. This, as we have seen, being 
the step between grape sugar and Carbonic acid, must 
either be Lactic acid, or something similar to it. It 
must be remembered that no food is usually taken in 
fever; this would at length quite cut oft* the usual 
source of this Lactic acid, which is the starch and 
sugar of the food, and render it necessary that the 
animal tissues should continue to undergo oxidation 
to maintain the animal heat. Rheumatism and Gout 
are an exception to this." 

Hence, to correct this deficiency of acid and ali- 
ment, neutralize superalkalinity of blood, allay fever, 
restore the equilibrium of chemico-organic action, 
calefaction, and nutrition, Lactic acid should be given 
in solution with sugar, or better still, in its natural 
connection with nitrogenized aliment, as in sour 



136 BASIC PATHOLOGY AND SPECIFIC TBEATMENT OF 

buttermilk, sweetened to taste. This supplies appro- 
priate medicine, refrigerant and refreshing drink, 
with the most essential food in an acceptable form to 
the palate and stomach at the same time, an impor- 
tant advantage — indeed, often vital necessity in yellow, 
ship, typhus, puerperal, and other low fevers and 
correlative diseases, in which the more substantial 
animal aliment in the usual forms is frequently re- 
pugnant and the stomach so intolerant of everything. 
In the absence of better remedies the juice of sauer 
kraut, sour cider, and sour wine, might be resorted to 
as acid remedies in zymotic, septic, contagious, scor- 
butic, putrescent and allied diseases, though in 
general, spirituous liquors of all kinds are objection- 
able in such maladies, as alcohol parches the mouth 
and throat, irritates the stomach and liver, diminishes 
the secretion of the gastro-intestinal canal and general 
system, dries the skin, increases thirst, prevents 
oxygenation, arterialization, hsematosis and normal 
chemico-organic metamorphosis, pollutes and induces 
a toxic and scorbutic condition of the blood, and 
promotes congestion, inflammation, and hcemorrhage, 
particularly of the stomach and liver, with special 
tendency to emesis and those forms of disorder ex- 
pressed in the general term of " mat des ardens" which 
are usually so predominant in typhus, yellow, ship, 
bilious, puerperal, and other fevers, with erysipelas, 
diphtheria, infectious, and septic diseases generally. 
In fact, alcoholics everywhere the world over, espe- 
cially in hot weather and tropical climes, are subject 
to abnormal thirst, dyspepsia, congestions, inflamma- 
tions, and defluxions of stomach, liver, lungs, brain, 
and kidneys, with gastric, bilious, blood, nervous, and 
epidemic maladies, that disable and destroy them 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 137 

largely. Hence alcoholic liquors are contraindicated 
in typhus, ship, yellow, bilious, puerperal, and all 
other fevers, with small-pox, erysipelas, diphtheria, 
septic and scorbutic diseases generally. They are 
unnecessary even in small quantities for stimulant 
purposes, which at best is but temporary and soon 
followed by reactive depression, or sedation, as phos- 
phoric acid and ol. terebinth., with other agents, are 
superior, and far more appropriate not only as 
stimulants, but also for other essential uses in such 
cases, their action being more direct, physiological, 
radical, permanent, and remedial, in marked contrast 
with the noxious, morbific, and baneful effects of 
alcohol both immediate and remote, unless used with 
the utmost circumspection in small quantities, there 
being no greater fallacy than its free use as a stimulant 
and food, when it really enervates, relaxes, narcotizes 
and starves the system, and acts as a pernicious 
poison, both directly and indirectly. 

Alcohol neither supplies nutriment, heat, nor force 
to the vital economy, but robs it of all, and is in no 
sense an aliment, but a noxious drug, that coagulates, 
hardens, toughens, and renders food less digestible; 
diminishes, precipitates, and prevents the transform- 
ing action of the digestive ferments; arrests the 
chemical processes of digestion, oxidation, and ar- 
terialization ; counteracts sanguification, assimilation, 
and nutrition; and subverts both formative and 
retrogressive chemico-organic metamorphosis; as well 
as deadens, disorders, and destroys the higher 
dynamical functions of nervous, mental, and moral 
life, of which the common phenomena of intoxication, 
and the myriads of poisoned, diseased, degraded, and 
dying human beings therefrom are ample evidence 



138 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

presented everywhere throughout the world, alcohol- 
ism being a prevalent endemic in all times and climes, 
whenever or wherever this potent alcoholic poison 
under whatever guise, is ingested. Therefore, as 
alcohol does not render food more, but less digestible; 
does not quench, but produces thirst; does not en- 
hance, but nullifies the activity of the digestive 
ferments; does not nourish, but starves the body; 
does not increase, but diminishes oxygenation and 
calorification ; does not promote, but prevents sangui- 
fication; does not purify, but corrupts the blood; does 
not facilitate, but subverts normal chemico-organic 
metamorphosis and depuration ; does not augment, 
but lessens vital energy; does not invigorate, but 
enervates the system ; does not support, but destroys 
health ; does not prevent, but induces disease ; does 
not refine, but debases the physical, mental, and 
moral nature ; does not diminish, but increases vice, 
crime, and licentiousness, with concomitant evils; 
does not promote, but subverts healthy procreation, 
and hereditarily entails deformity, dementia, de- 
pravity, and debasement of body, mind, and morals 
upon progeny; does not ennoble, but brutalizes 
mankind; does not lengthen, but shortens life; it has 
no quality or application whatever as a food and 
beverage, and but a limited use as a drug. Though 
the principal medicinal value of alcohol is as a stimu- 
lant, yet it is but an evanescent excitant in small 
quantities, and a powerful intoxicant, narcotic, and 
relaxant, or stupefacient and depressant of body and 
mind, in large or frequent small doses, its secondary 
and reactive depressing with its other deteriorating 
effects so predominate, as to render it inapplicable 
for prolonged stimulant with collateral restorative 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 139 

purposes. In fact, in many respects, independent of 
its obnoxious properties, it is inferior as a remedial 
agent to other drugs, especially the oil of turpentine, 
to which we will now invite attention as an efficient 
substitute therefor, in its connection more particularly 
with malignant fevers and correlative diseases, and 
disorganizing and depressed conditions generally. 

Oleum Terebinthince. The oil of turpentine is a 
powerful stimulant, disinfectant, germicide, anti- 
zymotic, antiseptic, alterative, haemostatic, depurant, 
secernant, diaphoretic, diuretic, purgative, and anthel- 
mintic, and externally a rubefacient and vesicant. It 
stimulates the heart and circulation, brain, nervous, 
and general system, disinfects and depurates the blood 
and body, obviates the tendency to, and checks 
haemorrhage and putrefaction, promotes normal 
secretion of the air-passages, mouth, gastro-intestinal 
canal, skin, and kidneys, destroys microzymes, in- 
testinal and other parasites, and acts as a general 
alterative, resolvent, stimulant, and corroborant. It 
has, moreover, the superior attribute of being so 
volatile that it can readily be introduced into the 
blood and body ad saturandum, by involuntary inhala- 
tion without dosing the stomach, which is especially 
important in diseases of the throat, air-passages, lungs, 
heart, and blood, ship, typhus, bilious, puerperal, and 
other low fevers, cholera, collapse, and depressed 
conditions of the system in general, though sometimes 
its local action on the stomach and bowels is desirable 
therein, as in the hemorrhagic and ulcerative states 
of yellow and enteric fever, serous, choleraic, and 
other asthenic gastro-intestinal affections. It is also 
readily absorbed through the skin and rectum, 
rapidly enters the circulation and appears in the urine 



140 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

and breath, so that its volatility, penetrability, diffusi- 
bility, stimulant, and other properties render it 
peculiarly valuable in the treatment of many dis- 
orders of a toxsemic, infectious, and adynamic char- 
acter, particularly when patients are intolerant of 
gastric medication or in a depressed, collapsed, and 
insensible state, in which it has extensive and varied 
uses as demonstrated by the following evidence from 
different sources. 

Thus, with other applications, Dr. Waring states 
[Practical Therapeutics), that in " Typhus and Typhoid 
Fevers and in the advanced stages of continued and 
inflammatory Fevers, the Spirit of Turpentine by 
mouth, in enemata or externally in fomentation, is a 
remedy of the highest value, when the vital energies 
are greatly depressed, when Coma or Stupor are present, 
or if Delirium with Subsultus Tendinum, etc., exists. Tur- 
pentine, either by mouth or in the form of enema, 
often rouses the vital powers, and exercises the most 
beneficial influence. In the Tympanitis of Fever, it also 
proves most essentially useful, Drs. Graves, Copland, 
and others speak highly of its efficacy; the former 
advises it in doses of f 5 j, with f 5 iss of Castor Oil, to 
be repeated every sixth hour; and the latter ad- 
ministers it in enemata, and applies it externally to 
the abdomen in fomentation, I have seen striking 
benefit result from its employment; indeed there are 
few remedies which deserve more confidence. In 
Intestinal Haemorrhage, Hiccough, etc., it also proves 
highly serviceable, removing these conditions and 
tranquillizing the nervous system. Prof. Huss states 
that, in the epidemic of Typhoid Fever which pre- 
vailed at Stockholm in 1841-2, he found Turpentine 
fomentations extremely useful, they were applied to 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 141 

the abdomen when the diarrhoea was profuse, and to 
the chest w T hen pulmonary complications existed. Its 
external application should never be omitted in the 
latter stages of Typhus. It may also be given in- 
ternally with advantage. Dr. Shapter considers that 
in the third or last stage of Remittent Fever, the Oil of 
Turpentine, in doses of gutt. xxx, is perhaps one of 
the most safe and useful medicines which we can 
employ. He remarks, that it often immediately con- 
trols the character of the symptoms, and changes en- 
tirely the nature of the alvine secretions. Stimulants, 
etc., are advisable at the same time. Dr. Ward, in 
the treatment of the Malarious Intermittens of Ceylon, 
found great advantage from the administration of 
foss-foj of Spirits of Turpentine (with a sufficient 
quantity of Castor Oil to act as a cathartic) at the 
commencement of the cold stage. The remedy was 
repeated every succeeding cold stage, and he frequently 
found no other treatment was required. In the Bron- 
chitis of Typhus Fever and other Adynamic Fevers, the 
effects of Turpentine internally, to use the words of 
Dr. Murchison, are sometimes marvellous. In 
extreme cases, when the tubes are filled with secre- 
tion, the face livid, and the patient has not the 
strength to cough, or when other remedies fail, 
recourse should be had to Turpentine. It may be 
given as follows: ]^. 01. Terebinth. ^ x-xx, Ether 
Sulphuric, vel Chloric, ^ xv-xxx, Spt. Juniper Co. 
^ xxx, Mist. Acacia f 5 iss, M. This may be repeated 
every two hours at first, until the desired effect is 
produced. After a few doses, the patient often begins 
to cough and to expectorate large quantities of viscid 
mucus, with great relief to the respiratory symptoms. 
Under its use the urine is increased." 



142 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

" In Puerperal Fever, the internal exhibition of the 
Oil of Turpentine, in doses of one or two tablespoon- 
fuls every three or four hours, in cold water, and 
sweetened, was first proposed by Dr. Brenan, of 
Dublin. He regarded it as a specific, and in this 
opinion he is joined by Drs. Douglass, Blundell, 
Copland, and other judicious practitioners. Dr. 
Murphy agrees with Dr. Copland in stating that there 
is certainly no remedy so efficacious as a decided and 
judicious use of the Spirit of Turpentine in doses of 
f § ss, with Castor Oil, every three or four hours." 

" In Inflammation, Dr. Copland observes that after 
watching its effects for thirty years, he believes there 
is no remedy more deserving of confidence, if ap- 
propriately and prudently prescribed. The operation 
of this medicine depends upon the dose, the frequency 
of repetition, and the combination of it with other 
remedies. Hence it may be made available in every 
form of inflammation/ 5 

" In Hemorrhage, the Oil of Turpentine has long 
been highly esteemed as a styptic. Its use is generally 
confined to atonic and passive Haemorrhage, but Dr. 
Copland considers that the existence of inflammatory 
action does not contraindicate its use, for it lowers, he 
observes, vascular excitement, and prevents effusion, 
and the formation of coagulable lymph, especially 
when given in sufficiently large or repeated doses. 
When the powers of life are much impaired, and after 
copious evacuations of blood, small and frequent doses 
of it only ought to be given, conjoined with tonics, 
aromatics, restoratives, etc." 

" In Purpura Hcemorrhagica, Dr. Neligan employed 
the oil of Turpentine with invariable benefit. He 
gave it in doses sufficient to purge freely, which 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 143 

object is more certainly obtained by combining it 
with Castor Oil." 

Others testify to the same effect, but the haemo- 
static, stimulant, and alterative effects of turpentine 
can in general, be obtained by smaller and more 
frequent doses by the mouth, rectum, and lungs in 
inhalation especially, without purgative or other per- 
turbative treatment. 

Further evidence is presented of its efficacy in 
various forms of haemorrhage, and general experience 
testifies that in gastric, intestinal, uterine, pulmonary, 
renal, purpuric, and other forms of hremorrhcea, 
especially of an atonic character, the oil of turpentine 
is very efficient and often of itself sufficient to arrest 
the bleeding as well as to correct the hemorrhagic 
diathesis, but may be often advantageously combined 
with other remedies to meet special indications in 
particular cases. 

Moreover, in defective or perverted secretion of the 
air-passages, mouth, throat, gastro-intestinal canal, 
and other parts, especially of the kidneys, the oil of 
turpentine is extremely useful, and will sometimes 
succeed in restoring the urinary and other secretions 
when the most active secernants and diuretics have 
failed. Besides, in serous, anasarcous, choleraic, and 
purulent defluxions it is a very efficient remedy 
exhibited both internally and externally, and particu- 
larly by voluntary as well as involuntary inhalation, 
when a more speedy and decided effect is required, as 
in chill, effluxion, and prostration generally. 

Furthermore, in conditions of a necnemic, phleg- 
monous, putrefactive, and lethal character, it is highly 
useful, as for example, in "Erysipelas. Mr. Nunnely 
observes that it is certain that in some instances 



144 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

where coma has been intense, the pulse sinking, the 
tongue dry and glazed, and the teeth imbued with 
sordes, after other remedies have been abandoned in 
despair, the administration of the Oil of Turpentine 
has apparently saved the patient. In extreme cases it 
should always be employed, and may be given in 
the manner advised in Typhus Fever (ante). Dr. Cop- 
land advises Turpentine fomentations to be locally 
applied. 

" Ulcers of the Extremities. The internal use of tur- 
pentine appears in these cases to hasten the healing 
process. Mr. H. Hancock, of Charing Cross Hospital, 
relates a case illustrative of its efficacy. Water 
dressings were applied locally, and the following 
mixture was given internally: 1^. Sp. Terebinth. 
f5vj, Pulv. Acacia 5vj, Aq. Menth. Pip. f^vij, 
M. Sumat. f § j ter in die." — (Ibid). 

Besides atonic and chronic ulcers, oil of turpentine 
is specially applicable for the prevention and treat- 
ment of bed-sores, and all the disorganizing, 
ulcerated, gangrenous, and sloughing tendencies — 
internal and external, of typhoid, diphtheria, angi- 
nose, and asthenic conditions generally, in which it 
must necessarily be conjoined with a due supply of 
appropriate acid, mineral, and alimentary basic 
principles, essential for normal construction, nutrition, 
reparation, and life action. 

To further exhibit the valuable medicinal applica- 
tions of ol. terebinth. I present the following from the 
U. S. Dispensatory, by Dr. Geo. B. Wood : 

" Oil of turpentine is stimulant, diuretic, occasion- 
ally diaphoretic, anthelmintic, in large doses cathartic, 
and externally rubefacient. Swallowed in moderate 
quantities it produces a sense of warmth in the 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 145 

stomach, accelerates the circulation, and increases 
the heat of the skin, without especially affecting the 
functions of the brain. In small doses, frequently 
repeated, it stimulates the kidneys, augmenting the 
secretion of urine, and often producing, especially if 
long continued, painful irritation of the urinary pas- 
sages, amounting sometimes to violent strangury. . 
. . In large doses it occasions slight vertigo, or a 
sense of fulness in the head, sometimes amounting to 
intoxication, attended frequently with nausea, and 
succeeded generally, though not always, by speedy 
and brisk catharsis. ... In some constitutions it 
produces, even when taken internally an erythematic 
eruption on the skin." 

"The oil is employed in numerous diseases. As a 
stimulant it sometimes proves serviceable in low 
forms of fever. We have found it extremely useful 
in the advanced stage of typhoid or enteric fever, and 
especially in cases in which the tongue has partially 
or completely thrown off its fur in flakes, and after- 
wards become dry, with a surface destitute of its 
ordinary papillary appearance, and often contracted 
and fissured. The remedy has, in our hands, proved 
almost uniformly successful under these circum- 
stances. With small doses of the oil frequently 
repeated, the tongue becomes moist and again coated, 
the tympanic state of the bowels disappear, and the 
patient goes on to recover as in a favorable case of 
fever. . . . The medicine has been recommended 
as a counter-irritant in yellow and puerperal fevers, 
and may undoubtedly be given with advantage in the 
later stages of these diseases, and in other instances of 
gastric and enteric inflammations, which require a 
resort to stimulation. ... It has also been much 



146 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

extolled as a remedy in neuralgia, in epilepsy, and 
tetanus, in passive haemorrhages, particularly from 
the bowels, in disordered conditions of the alimentary 
canal attended with sallow countenance, foul tongue, 
tumid abdomen, sour or fetid eructations, and general 
depravation of health, in obstructions of the bowels 
in chronic dysentery and diarrhoea, in obstinate gleets 
and leucorrhcea, in suppression of urine, and retention 
and incontinence of urine from debility, and in 
chronic nephritic and calculous affections. In certain 
states of dysentery, whether acute or chronic, when 
the tongue is quite dry, and smooth as if from defect 
of the papillary structure, no remedy has been so 
efficient in our hands as oil of turpentine. We have 
seen it also very beneficial in haemoptysis. As a 
vermifuge it is highly esteemed especially in cases of 
taenia." 

" The dose for ordinary purposes is from five to 
thirty drops every hour or two in acute, and three or 
four times a day in chronic diseases, administered on 
sugar, or in emulsion with gum arabic, loaf sugar, 
and cinnamon or mint water. No remedy is more 
effectual in tympanites than the injections of the oil 
of turpentine. From half a fluid-ounce to two fluid- 
ounces may be administered suspended by the yolk of 
eggs in half a pint or pint of water, or some mucilagi- 
nous fluid. Externally applied, oil of turpentine 
irritates and inflames the skin, and in low forms of 
fever with coldness of the surface, is when heated, one 
of the most efficacious rubefacients." 

These lengthy extracts are presented to show more 
strongly the special adaptation of the oil of turpentine 
to the treatment of the inflammatory, necraemic, in- 
fectious, disorganizing, putrescent, and adynamic 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 147 

states of ship, typhus, yellow, malarial, puerperal, 
congestive, enteric, and other fevers, with erysipelas, 
diphtheria, small-pox, purpura, haemorrhages, gastro- 
intestinal disorders, choleraic and other defluxions, 
and toxemic, zymotic, septic, contagious, and de- 
pressed conditions general^. It is thus especially 
indicated therein as an energetic stimulant, disinfect- 
ant, antiseptic, germicide, haemostatic, diuretic, 
diaphoretic, general secernaut, alterative, resolvent, 
and restorative. As a hemostatic in scorbutic, ne- 
cramic, and purpuric conditions particularly, it will 
prove in general more useful than any other remedy 

" it has been used with success in almost every 
form of hcemorrhage, but most successfully when the 
bleeding was passive. The special affections include 

(axis, hcemaiemesis, hcematuria, menorrhagia, past par- 
turn haemorrhage, purpura^ and the multiple haemor- 
rhages occurring under the iniluence of the haemor- 
rhagic diathesis. Even in external and traumatic 
haemorrhages it has proved efficient. Its efficacy 
justifies the opinion of John Hunter, who termed it 
' the best, if not the only true styptic.'" — Dr. Alfred 
Stille (National Dispensatory). 

Oil of turpentine is not only thus applicable to 
arrest bleeding and exudation, but also to subvert the 
hemorrhagic and colliquative diathesis, prevent the 
necraemia and transudation of the blood in its entirety 
from the various tissues and organs, as in scurvy, 
black vomit, etc., with the separate effusion of its 
albuminous and aqueous constituents, as in leucor- 
rhcea, dropsy, and cholera in its various forms, in 
fact, in haMnorrhagic, lymphoidal, and serous deflux- 
ions generally. It is thus efficient both as a prophy- 
lactive and curative of the necnenric, transudative, 



148 BASIC PATHOLOGY AND SPECIFIC TBEATMENT OF 

and diarrhceal disposition, and likewise of the general 
typhoidal and collapsing, with their concomitant fatal 
tendencies, though as all such abnormities depend so 
directly upon the ammoniacal and superalkaline 
dyscrasia, its efficiency may be largely enhanced 
therein by the conjoined use of acids, with ergot, iron, 
and other constringing and tonic agents. Besides, in 
the minor affections as a cardiac and general stimu- 
lant, etc., and substitute for alcohol, it may often be 
given beneficially in small and frequent doses on 
su^ar, or in emulsion with aromatics and tonics. 

From its volatility the oil of turpentine may be 
given more or less freely and continuously by inhala- 
tion in ordinary inspiration, by keeping a cloth 
saturated with it in front and near the face of the 
patient, as well as by its more general diffusion in the 
air the patient breathes, supplemented if necessary by 
voluntary inhalation, especially in cases of sudden 
depression as in cholera, yellow fever, uterine haemor- 
rhage, chills, and syncope from any cause, if the 
patient be able to make the necessary effort. Other- 
wise it may be given by the mouth or bowels, or both, 
particularly for its more immediate internal local 
effects upon the gastro-intestinal canal. Whenever 
indicated in all such diseases and depressed conditions, 
I thus habitually exhibit the oil of turpentine by 
inhalation in preference to its administration by the 
mouth or rectum, more or less freely according to 
necessity, until its specific effects are obtained, 
although the latter method is also conjoined or more 
exclusively employed where the occasional or local 
internal use of this valuable remedy is necessary, 
graduating of course, the dose and mode of administra- 
tion according to the special indications therefor and 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 149 

effects required, though a gentle continuous disinfect- 
ant, diaphoretic, diuretic, alterative, and stimulant 
influence may usually be kept op by moderate 
quantities steadily inhaled in ordinary breathing, 
better than by occasional doses by the stomach or 
bowels. From my own general and favorable expe- 
rience therewith in the various scorbutic, necraemic, 
septic, typhoid, infectious, and depressed states of 
system, I firmly believe that the free and appropriate 
use of the oil of turpentine in the adynamic and 
hemorrhagic states of vellow fever, as well as in 
cholera and allied diseases, will prove invaluable, 
both as a preventive and curative of some of their 
most dangerous symptoms and tendencies. I therefore, 
strongly urge its free exhibition therein, both by the 
lungs and stomach, or rectum, as may be required, 
beginning usually with small quantities and gradually 
increasing according to necessity, until the desired 
effect is secured, this, rather than the quantity used 
being the better guide, in every disease, always how- 
ever, bearing in mind that in excess it irritates and 
inflames internal organs with external tissues, as well 
as intoxicates and enervates the nervous and general 
system, or induces anesthesia, for which indeed, it 
may be sometimes employed advantageously, while 
exceptionally, as stated by Dr. Waring (Practical 
Therapeutics), " In some persons, Turpentine, in any 
form, or in any dose, produces very unpleasant effects: 
coma, intoxication, violent strangury, eruption of the 
skin, etc." 

The beneficial iufluence of the oil of turpentine is 
not, how T ever, thus limited exclusively to the patient, 
for its general diffusion in the air destroys the infec- 
tious principles therein, as well as prevents their 



150 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

development and thereby protects the attendants and 
others exposed, against contagious miasms and dis- 
eases, as in diphtheria, typhus, small-pox, scarlatina, 
cholera, and others of a less virulent character, it 
being a potent ozoniferer, disinfectant, and germicide, 
as well as stimulant and restorative, but as it is 
inflammable it must not be too freely disseminated in 
the air where there is any danger of fire. 

Other essential oils as of peppermint, cinnamon, 
eucalyptus, with thymol and their analogues, singly 
or combined with turpentine and other less pleasant 
remedies, with the juice of alliaceous plants, as of 
onion, garlic, etc., the activity of which depend upon 
an essential oil, are also applicable in adynamic fevers 
and conditions of system. These oils and cognate 
agents may also be inhaled, taken by the mouth or 
applied to the surface. One of the most common and 
useful of this class is garlic, which may be employed 
both as a condiment and medicine at the same time. 
" When it is taken internally, the oil is speedily 
absorbed, and pervading the system, becomes sensible 
in the breath and various secretions. Even ex- 
ternally applied, as to the soles of the feet, it imparts 
its odor to the breath, urine, and perspiration, and, 
according to some writers, may be tasted in the 
mouth. Its effects on the system are those of a 
general stimulant. It quickens the circulation, excites 
the nervous system, promotes expectoration in debility 
of the lungs, produces diaphoresis or diuresis accord- 
ing as the patient is kept warm or cool, and acts upon 
the stomach as a tonic and carminative. . . . Ap- 
plied to the skin it is irritant and rubefacient, and 
moreover, exercises in some degree its peculiar 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 151 

influence upon the system, in consequence of absorp- 
tion. . . . The juice is said sometimes to check 
nervous vomiting, in the dose of a few drops. If 
taken too largely, or in excited states of the system, 
garlic is apt to occasion gastric irritation, flatulence, 
hemorrhoids, headache and fever/' — U. S. Dispensa- 
tory. Hence the use of the juice or oil of garlic is 
indicated in cholera, and other atonic serous, hemor- 
rhagic, catarrhal, albuminous and purulent defluxions, 
as well as in congestive, malarial, and low fevers, 
with scorbutic, collapsed, and depressed conditions 
generally, both exhibited internally and applied to 
the surface, and may be taken in food and medicine 
for preventive as well as curative purposes. 

In the more purely hygienic with the medicinal 
treatment of typhus, yellow, malarial, puerperal, 
enteric, and other asthenic fevers, with small-pox, 
erysipelas, diphtheria, cholera, septic, infectious, 
putrescent, and adynamic states of the system in 
general, special effort should be made to insure the 
proper oxygenation of the blood, haematosis, chemico- 
organic metamorphosis, and depuration of the fluids, 
organs, secretions, and entire system by a due supply 
of pure air with other arterializing agents, of which 
oxygen, peroxide of hydrogen, and nitrous oxide will 
prove the most useful, though it is probable that 
nitromuriatic acid owes some of its efficacy to the 
oxygen as well as chlorine it supplies to the system, 
besides its compound action as an acid. Of oxygen 
itself little need be said, as it is well known and less 
active in a free than nascent state, though quite use- 
ful, but of the peroxide of hydrogen, which yields it 
in this condition, much may be usefully expected. 



152 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

With regard to the physiological influence and 
therapeutical effects of peroxide of hydrogen. " Dr. 
B. W. Richardson, of London, found that to venous 
blood, deprived of its fibrin, it imparts oxygen, with 
an increase of heat, and a change of the color to red. 
Fibrin and cellular tissue cause it to evolve oxygen. 
Sugar and starch are decomposed by it, giving out 
carbonic acid. Albumen, gelatin, urea, and cutaneous 
tissue have no effect upon it. Injected into the left 
cavities of the heart of an animal, it restores the 
irritability of that organ, but has an opposite effect in 
the right cavities. Thrown into the arteries imme- 
diately after death, it restores for a time, the contrac- 
tile power of the muscles, and suspends cadaveric 
rigidity, while it counteracts the influence of various 
medicinal substances that cause muscular spasm. Dr. 
Richardson inferred from his experiments that the 
peroxide might be found useful as an antidote to the 
narcotic poisons, as a local application to gangrenous 
ulcers, and as an internal remedy in low forms of 
fevers." From numerous trials he found it of value 
in various diseases, as rheumatism, whooping-cough, 
scrofula, bronchitis, phthisis, etc. "Dr. Richardson 
recommends that a solution of the peroxide should be 
used charged with ten volumes of oxygen, the dose of 
which may be from one to four fluid-drachms, freely 
diluted with water. There are so many substances 
which decompose the peroxide, that, as a general 
rule, it is best given without addition; at least nothing 
should be allowed to remain long in contact with it." 
— (U. S. Dispensatory). 

These properties render the peroxide of hydrogen 
peculiarly appropriate in cases requiring oxygenation 
and vitalization, with disinfection and depuration of 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 153 

the blood and system in general, hence applicable in 
typhus, yellow, malarial, bilious, enteric, puerperal, 
and other asthenic fevers, with variola, choleraic, 
toxsemic, septic, contagious, colliquative, atonic, and 
depressed conditions generally, especially with gastric 
and hepatic torpor, as according to Dr. Richardson, 
"In Jaundice it exercises an excellent effect by im- 
proving the digestion, and causing a free secretion 
[of bile?]"— (Waring' s PracL Thera.). As it also 
increases the secretion of urine, it is specially indi- 
cated in cholera, albuminuric, uremic, with dropsical, 
and correlative abnormities. It aflords a convenient 
method of exhibiting oxygen, and will doubtless 
prove useful in all cases requiring that vitalizing 
agent. 

Nitrous oxide, in some respects, is still better adapted 
to the preventive and curative treatment of typhus, 
yellow, and other low fevers, with choleraic, septic, 
infectious, and malarial diseases, as well as adynamic 
disorders generally, particularly in the prodromic chill 
and concomitant depression in the acute stage, as well 
as before the outbreak of the disease, though it is 
applicable throughout in asthenia, to destroy the 
morbific factors and counteract the pathological 
tendency ab initio, and in convalescence to restore the 
normal tonicity, as it is very active in oxygenating the 
blood, promoting digestion and nutrition, increasing 
the hepatic, renal, and other secretions, depurating the 
body, stimulating the brain, nervous, muscular, and 
general system, and breaking up the malarial cachexia, 
with other baneful dyscrasia, promptly resolving their 
concomitant abnormities, and restoring healthful vigor 
of body and mind. Moreover, in all cases of sus- 
pended animation, prostration, or sudden collapse, as 

H 



154 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

in asphyxia, swooning, depression from exhaustion, 
hemorrhage, serous and other defluxions, as well as 
malarial and congestive chills, transudative affections, 
with asthenic states and debility in general, nitrous 
oxide is specially applicable as a powerful counter- 
active, exhilerant, vitalizer, invigorant, and restorative. 
In particular, it will doubtless prove more actively 
efficient in rousing the system and exciting reaction 
in the collapse of cholera, and all states of depression 
than any other known remedy. Indeed, it is far 
superior to oxygen and other agents as a stimulant, 
tonic, resolvent, and corroborant in depressed condi- 
tions. For stimulant purposes it should be given in 
small and frequently repeated doses, or continuously 
for a time in moderate exciting quantities by inhala- 
tion or otherwise, exhilerating rather than anaesthetic 
doses being required for the due invigoration of the 
system in all forms of depression. In fact, the prompt 
and powerful revivifying, exhilerating, and invigor- 
ating influence of nitrous oxide upon the animal 
economy is so decided as to render it applicable for 
more varied and extensive sanitary and medicinal 
purposes than almost any other known agent, a specific 
detail of which I hope to present ere long in a special 
work upon the subject. 

Besides these and the oxymuriatic and chlorinated 
preparations, with the usual alteratives, antiperiodics, 
and tonics, there are other agents more or less applicable 
in ship, yellow, malarial, and septic fevers, infectious, 
colliquative, and correlative diseases, as carbolic, sul- 
phurous, and salicylic acids, with their compounds of 
soda more particularly, from their general neutraliz- 
ing, febrifuge, disinfectant, antiseptic, antizymotic, 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 155 

and depurative effects. From its mildness and effi- 
ciency as a febrifuge, antiperiodic, and tonic, and its 
conversion in the system into salicylous acid, Salicin 
is likewise appropriate in yellow fever as in cognate 
maladies. Iodine and bromine with some of their 
compounds judiciously administered, are also applica- 
cable therein, particularly the hydrobromic acid in 
the active febrile stage to allay thirst, quiet the 
stomach, and for its general soothing, antipyretic, 
antalkaline, disinfectant, and resolvent effects. In 
fact, it promises to be a most efficient and valuable 
febrifuge, antizymotic, antiseptic, nervine, and anti- 
phlogistic in all acute and sthenic fevers, contagious 
diseases, superexcitable, and inflamanatory conditions 
of system, both singly and in conjunction with 
other antipyretic, anodyne, disinfectant and resolvent 
measures. 

When the bowels, which are so apt to be constipated 
in yellow, bilious, malarious, and other varieties of 
fever, do not respond sufficiently to the acid medica- 
tion and regimen, with the varied incidental measures, 
they may be relieved with small doses of citrate of 
magnesia or phosphate of soda, which latter may be 
given like common salt in broth and other food; or, 
perhaps better still in general, when there is much 
local gastro-intestinal irritation, with the more con- 
servative laxatives of ox-gall, raw eggs beaten up in 
water with salt added, or the chloride of sodium 
separately, yeast, glycerine, olive and castor oil, and 
similar nutrient and emollient defecants; while in 
torpidity, the more active cholagogues and purgatives 
are applicable, as podophyllin, iridin, aloin, etc., and 
even croton oil, that may be readily taken in pill with 
little disturbance of the stomach, though free purga- 



156 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

tion, and hydragogue catharsis especially, is usually 
objectionable in these affections from being too debili- 
tating. Yet, croton oil is said to be quite efficient in 
yellow, bilious, and malarious fevers, in improving 
the secretion, and unloading the gall-bladder of large 
quantities of dark bile, though its general effect is 
hydragogue and energetic, but, "When its action is 
excessive, a draught of Lime or Lemon juice affords 
almost immediate relief. . . . In the Bilious Re- 
mittent Fevers of India, Dr. McGregor regards Croton 
Oil as one of the most efficacious remedies we possess. 
. . He found it succeed in procuring the evacua- 
tion of vitiated bile when Calomel, Jalap, and other 
purgatives had failed/' ( Waring' s Pract. Therapeutics.) 
But to avoid hypercatharsis therefrom, croton oil 
should be given in small doses of half a drop or less, 
alone or with other remedies occasionally until a 
moderate action is secured. When a more direct 
cholagogue effect is required small doses of ^'chloride 
of mercury may be exhibited, calomel being danger- 
ous in conjunction with other preparations of chlorine, 
though perhaps podophyllin and its analogues would 
sometimes be preferable. The bichloride, aloin, and 
others of a like character, with the more stimulant 
secernants and tonics, as pilocarpin for diaphoresis, 
quinia, strychnia, etc., may also be introduced sub- 
cutaneously, as well as by the gastro-intestinal canal, 
bat this brings us to the consideration of surface 
medication. 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 157 

IV. 

EXTERNAL TREATMENT. 

The direct application of remedies to the abdomen 
and general surface of the body is also a very efficient 
method of medication, especially applicable when the 
administration of drugs by the alimentary canal is 
objectionable. Thus the application to the abdomen 
of aloin, croton, castor, and other oils* hydrarg, 
ftichloride, and other cathartics aud medicaments 
properly diluted, may be sufficient to keep up a 
soluble state of the bowels and favorably influence 
the system in- general in times of emergency. The 
application of the mineral and vegetal acids to the 
surface is especially efficacious both for their local 
internal and constitutional effects as well as disinfect- 
ant purposes in infectious diseases, hepatitis, jaundice, 
bilious and malarial fevers, with torpor of liver and 
bowels, ascites, and other disorders, and is particularly 
indicated in yellow and allied fevers, in which their 
free application by frequent lavements or the bath, 
would doubtless materially help to overcome the 
disease and restore the patient as in corresponding 
disorders, in which the nitric and hydrochloric acids, 
or nitro-hydrochloric acid are thus so very efficient. 

" Nitromuriatic acid was first brought to the notice 
of the profession, in consequence of the favorable 
report of its efficacy as an external remedy in hepa- 
titis, made by Dr. Scott, formerly of Bombay. When 
thus employed, it produces a tingling sensation of the 
skin, thirst, peculiar taste in the mouth, and occasional 
soreness of the gums and plentiful ptyalism ; and at 



158 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

the same time stimulates the liver, as is evinced by 
an increased flow of bile. It is used either by spong- 
ing, or in the form of a local or general bath. When 
applied by sponging, the acid is first diluted so as to 
have the sourness of strong vinegar. When used as 
a foot-bath, three gallons of water, contained in a 
deep narrow wooden tub, may be acidulated with six 
fluidounces of the acid. In this the feet and legs are 
to be immersed for twenty minutes or half an hour. 
The bath may be employed at first daily and the 
sponging may be used at the same time. The bath is 
said to be effective in promoting the passage of biliary 
calculi. The solution prepared for a bath is acidu- 
lated with two fluid-drachms of the acid, to make up 
for the waste by evaporation. The bath should have 
a temperature of about 97°, which may be attained by 
heating part of the acid solution and throwing it back 
into the remainder." — {U. S. Dispensatory). 

" In Chronic Hepatitis, and in Acute Hepatitis when 
the acute symptoms have been subdued by depletion and 
other antiphlogistic measures, Nitromuriatic Acid 
both internally and externally, has been used with 
great advantage, Mr, Annesley, who employed it 
extensively, placed great reliance on it, and Sir J. 
McGricor observes, after employing it in about 200 
cases, ' one fact we are clear and decided in, that the 
injury to the constitution is infinitely less from the 
acid than from the mercurial ointment, and that men 
are not half the time convalescent from the first as 
they are from the last remedy.' It is in the form of a 
bath that it is most used and proves most serviceable. 
. . . In urgent cases a general bath to envelope 
the whole body may be used. If the acid-bath create 
much irritation of the skin the quantity of the acid 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 159 

may be diminished. . . . In Dropsy from disease 
of the Liver or Spleen, much service will accrue from 
the Nitromuriatic Acid bath, or from sponging the 
surface of the hypochondria, night and morning, with 
a warm lotion containing these acids or from the 
internal use of them. (Copland)." — Waring' s Practi- 
cal Therapeutics), 

Sponging and bathing the body with dilute vinegar, 
as well as its internal use is also very serviceable in 
the prevention and treatment of fevers, in infectious, 
septic, and scorbutic diseases. "Diluted vinegar 
forms an excellent lotion for sponging the body in 
fevers; under the same circumstances, it is an agree- 
able refrigerant drink, when properly sweetened; 
sprinkled about a sick room, it is extremely refresh- 
ing; and the vapor is useful in many affections of the 
throat." — [Ibid). Also in strong solution alone or 
with chloride of sodium is excellent as a gargle in 
diphtheria and other anginose affections. " The re- 
frigerant influence of diluted vinegar on the surface 
is undoubted, it not only diminishes heat, but allays 
pain. In Hcemorrhagic affections the cold feeling which 
it produces on the skin is extended to the whole 
system, hence the benefit derived from it in internal 
haemorrhages, and in inflammation of the cavities. 
. . . In general fever, sponging the body with 
vinegar and water is applicable in every case in which 
the skin is preternaturally hot, when no idiosyncrasy 
stands in the way." — (Ibid). 

Vinegar is also a direct styptic and antiphlogistic, 
with disinfectant properties, and has long been used 
as a prophylactive against infectious and epidemic 
diseases, but it is far inferior to the mineral nitric and 
hydrochloric acids or their compound nitro-hydro- 



160 BASIC PATHOLOGY AND SPECIFIC TBEATMBNT OF 

chloric acid. Solutions of chlorine, chlorinated soda, 
and their analogues are also efficient both for external 
and internal use for disinfecting, preventive and cura- 
tive purposes, as likewise carbolic, sulphurous, and 
salicylic acid, with solutions of thymol, eucalyptus, 
tar, and similar agents in infectious diseases as 
specially indicated. But as " prevention is better 
than cure," we will briefly consider the most appro- 
priate means therefor relating more directly to per- 
sonal purification and protection than general sanita- 
tion, which is usually thought to be all sufficient, yet 
is really only partially so, as it removes merely some 
of the extraneous, without at all touching the intrinsic 
and systemic sources of diseases, the most imme- 
diately active and prolific causes thereof in general. 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 161 

V. 

PREVENTION. 

Much diversity of opinion exists respecting the 
origin, contagiousness, and transmissibility of yellow 
fever, diphtheria, typhoid, and other diseases of a 
varied zymotic, septic, and infectious character, on 
the border line or intermediate between the markedly 
contagious and benign diseases, but which, like their 
analogue — erysipelas, vary in degree of contagiousness 
according to the energy of morbific force, or intensity 
of disease, conditions of system, and other favoring 
circumstances, hence ranging from the least innocuous 
to the most infectious, in every grade of activity, one 
being converted into the other according to the power 
of either or both special intrinsic and extraneous 
pathogenic agencies. Moreover, there is much differ- 
ence of opinion with regard to the spontaneous or 
secondary origin of such maladies, yet, this need not 
be, for in accord with the laws of nature, there is no 
valid reason why all the most malignant and contagious 
diseases may not originate spontaneously as well at one 
time as another, coeter is paribus, the same as innocuous 
disorders, their occurrence being but a matter of con- 
ditions, or intensity of morbific influences, and not of 
time, as exhibited in the spontaneous origin of puer- 
peral fever, erysipelas, and gonorrhoea, which arise 
de novo at all times alike whenever the pathogenic 
factors are brought together, and may be secondarily 
transmitted ad infinitum. Hence, it is most probable, 
that disease of all kinds, the most malignant and con- 
tagious as well as the less infectious and benign, 



162 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

originate spontaneously whenever the morbific factors 
and concurring circumstances are present without 
regard to time, person, or place, as in the beginning, 
this being as well in the present as at any former 
period, just the same as in the case of spontaneous 
combustion that will occur at any time or place, and 
the resulting fire spread indefinitely if sufficient com- 
bustible material be present, unless repressed by a 
counteracting power. Indeed, like combustible matter, 
the principal factors of the most malignant disease 
may co-exist, and yet, in the absence of a slight acces- 
sion or additional factor, may remain quiescent and 
innocuous or become active by accretion, as in the 
case of a proximate, extending into an exciting cause 
of disease, and just as gunpowder or dynamite may be 
all perfect for action up to the very verge of explosion, 
yet in the deficiency of an adequate degree of heat or 
concussion may remain inoperative and harmless 
though dangerous, instead of becoming explosive and 
destructive from the slightest increment of tempera- 
ture or force. 

Thus, as certain forms of contagious with all benign 
diseases originate spontaneously according to the 
presence and activity of special pathogenic factors, why 
should not all varieties of disease from the least in- 
fectious to the most malignant, in like manner develop 
de novo, and even life itself, whenever the specific con- 
ditions required therefor co-exist? as the same elements, 
forces and laws, that originally produced them still 
exist and act as formerly. Because life or one form of 
disease does not originate in certain ways it does not 
follow that they do not arise in other ways, any more 
than spontaneous combustion is impossible because it 
does not occur in some special mode. Necessarily for 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 163 

the spontaneous origin of fire, disease, and life, certain 
special factors are required, and without all of which 
no perfect evolution in either direction can result, yet 
with them specific action is certain. The spontaneous 
development of fire, life, and disease, is hence a matter 
of definite conditions, which may occur at any time in 
the present and future, as in the past. The same 
matter, force, and laws exist and act now as in the 
beginning, and the operation of the same influences 
or factors will produce the same result as well at one 
time as at another. Indeed, as observed elsewhere,* it 
is more than probable that if all fire, disease, and life, 
were instantly and absolutely extinguished, the latter 
as well as the former would again reappear in the 
natural order of things, in accordance with the force 
and laws or omnipotent power that originally produced 
and continues them and the universe in operation, as 
the laws of nature are uniform and immutable, and 
matter and force the same always and forever, while 
the same agencies will produce the same effects at all 
times alike. 

Thus, as the development of fire, disease, and life, 
is purely a matter of conditions the elements and forces 
which originated them at one period, can in like 
manner produce them spontaneously as well at any 
time, as amply demonstrated in the former, by the 
unquestionable frequent occurrence de novo of fire and 
disease — both benign and contagious and doubtless 
also of life itself, though this is not so manifest, yet, 
presumably just as positive. Therefore, as it is evident 
that all diseases, epidemic and contagious, specific and 
malignant, as well as benign, may originate sponta- 
neously at any time, anywhere, whenever concurrent 

* Natural Laws of Marriage. 



164 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

conditions are favorable, it is the part of wisdom and 
common sense to recognize the fact,- and try to dis- 
cover and remove the active morbific factors or pro- 
ducing causes thereof, to prevent their inception, as 
well as seek the means of cure and extinction after their 
development. While this is true of all disease, it is 
of special importance in pestilential, epidemic, and 
contagious maladies, of which small-pox, diphtheria, 
typhus, yellow fever, and cholera, are types, all of 
which may be prevented by due attention to personal 
hygiene, and avoidance of their extraneous as well as 
intrinsic causes, some of which are well known and 
preventable, while others may be neutralized or de- 
stroyed, though not fully determined. Thus, there is 
no question but that malarial disease spontaneously 
originates from certain baneful conditions of soil, air, 
and habitat, or filth, that may be avoided or subverted. 
Yellow fever partakes of the same nature and is 
spontaneously developed in a similar manner from 
local impurities as manifested in its occurrence de novo 
on ships, as well as in certain places constantly as the 
pestiferous conditions of its origin accumulate, the active 
extraneous as well as systemic causes of which may 
be prevented, removed, or destroyed the same as of 

ordinarv malarial disease. Cholera is in the same 

1/ 

category, though in its various forms, with typhus, 
diphtheria, and correlative maladies are dependent 
more directly upon avoidable morbific personal condi- 
tions, as well as extraneous agencies of filth, foul air, 
bad ingesta, etc. It is the height of folly therefore, 
to be looking outside and abroad or elsewhere for the 
sources of disease which exist and originate so freely 
within and around our own bodies, in our organiza- 
tion, ingesta, habits and environment. 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 165 

But, in whatever way such diseases originate, the 
genera] system of prevention and protection may be 
sammed up in the one word of cleanliness or purity 
of person and surroundings, of which personal hygiene is 
more directly essential than public sanitation, though 
the former is measurably dependent upon the latter, 
but for the greatest healthi'ulness all forms of pub- 
lication are required, general and individual, 
extraneous and intrinsic, molecular and systemic. 
To this end it is not essential to know all 
the factors of disease to be able to counteract 
and obliterate them, although desirable for more cer- 
tain and specific action, any more than to know the 
stinkin. incuts of a pile of filth to disinfect, or 

remove and get rid of the whole offensive mass at 
one Yet, when there is obscurity and doubt, all the 
probable morbific factors should be carefully guarded 
against, intrinsic as well as extraneous. It is not enough 
that all the usual general measures of sanitation have 
been adopted for the removal and disinfection of all 
kinds of tilth and extraneous sources of disease, as 
there are potent causes thereof depending upon the 
alimentation, personal habits, and modes of living, as 
well as tb ial organization of the vital economy, 

and which within themselves, are often sufficient to 
engender more or less serious disorder of the system, 
and without which the former would prove partially if 
not entirely innocuous, but with both together are 
very destructive of health and life. Hence there must 
be due regard paid to proper alimentation, habits and 
modes of living, with personal cleanliness and purity 
of the entire economy, or interior and molecular, as well 
as exterior of the body, to insure healthy nutrition, 
depuration, tonicity, and protection of the general 



166 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

system. Any person or organism surcharged with 
effete and noxious matter must have a depraved 
blood, and all the organs, functions, and secretions 
more or less disordered, and rendered unduly suscepti- 
ble to zymotic, septic, infectious, and other grave 
diseases, especially to such pestilential maladies as 
typhus, ship, yellow, congestive, puerperal and like 
fevers, with small-pox, erysipelas, diphtheria, cholera 
in all its forms, and similar plagues, as well as a host 
of the minor ills of life, and all preventable. 

Personal habits, ingesta, and modes of life in all 
climes, times, and conditions, on both sea and land, 
have often more to do with the predisposition to and 
the inception of these with other diseases, and espe- 
cially in hot weather, seasons, and climates, than 
extraneous agencies, these latter being more or less 
inoperative without the former, while both combined 
will produce the maximum of disease and death. 
This is exemplified everywhere in the history of sea- 
men, soldiers, travellers, individuals and communities, 
in fact human beings in every phase and state of 
existence, who by various irregularities of exposure, 
bad or improper, defective, inappropriate, or excessive 
ingesta, vicious courses, and otherwise, induce morbid 
conditions not only dangerous within themselves, but 
actively promotive of epidemic and other forms of 
disease. 

Prominent among the most general and actively 
predisposing and exciting causes of pestilential with 
other diseases, are those twin curses of humanity — 
tobacco and alcohol, the use of which is especially 
noxious in hot weather and climates in producing an 
ammoniacal, superalkaline, toxic and corrupt con- 
dition of the blood and atonic state of the system 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 167 

directly promotive of the development of typhus, ship, 
yellow, congestive, and other low fevers, with 
choleraic, septic, and adynamic disorders generally. 
We have shown how tobacco produces a superalka- 
line, scorbutic, and morbid state of the blood, both 
from its ammonia and nicotia, and other baneful ingre- 
dients, with depression of the nervous system and 
general vital energies, that renders those who use it, 
or are exposed to its pernicious influence specially 
liable to neeramiic, infectious, pestilential, and ady- 
namic diseases, thus not only of contagious, septic, and 
mephitic diseases, but choleraic, albuminous, hemor- 
rhagic, and serous deiluxions of all kinds, with 
inanition, marasmus, consumption, paralysis, and 
atonic affections in general. The use of all forms of 
* alcoholic liquors also induce a scorbutic, depraved, 
and poisoned condition of the blood, both directly and 
from consequent retention of effete matters, with 
malnutrition, mal-disintegration, aberrant innerva- 
tion, with superalkalinity, morbidity, and debasement 
of the entire system, that render it very susceptible to 
epidemic, septic, contagious, and other maladies, 
alcoholics everywhere being the first and foremost to 
succumb to pestilence, as well as disease and death 
from ordinary causes thereof. In the case of yellow 
fever " Dr. Car tw right, of iSfew Orleans, says that in 
one season in that city five thousand drinking men 
died with yellow fever before it touched a sober 
man." — (Alcohol and Hygiene, by J. Colman). But, 
assume that this was a mistake, and that only one- 
fifth or one thousand so died, that would still be a 
terrible mortality and unnecessary sacrifice of life, to 
say nothing of the concomitant suffering and misery 
from both the alcoholism and plague. Yet, how 



168 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

much the greater must be the debasement with de- 
struction of health and life when the baneful action of 
these two noxions agents — tobacco and alcohol, are 
combined, as is so generally the case even ordinarily, 
and so much the more in conjunction with the pestif- 
erous influence of yellow fever, typhus, cholera, and 
other malignant maladies, as well as the minor ills of 
life. 

The blood and body of every one charged with 
alcohol, ammonia, nicotia, colludine, and other poison- 
ous agents in spirituous liquors and tobacco, as well 
as other noxious matter introduced from without, 
with the abnormal products engendered within, and 
retained excrementitious materials from their per- 
nicious action upon the system, cannot fail to be 
disordered to such a degree as to render them un- 
usually vulnerable to pestilential diseases and morbific 
influences generally. It is obvious therefore, that the 
use of these two potent agents of infectious, with 
ordinary disease, as of evil effects in general upon the 
physical, mental, and moral nature of mankind, 
should be avoided altogether, but as few will be 
induced to adopt this most effective and radical mode 
of protection, the many must necessarily bear the 
consequences of indulgence therein, in the concomi- 
tant illness, suffering, and degeneration, with prema- 
ture and often sudden termination of existence there- 
from, as well as the increased susceptibility to the usual 
diseases and devastating epidemics which they would 
otherwise escape. 

The pernicious effects of these baneful agents — 
tobacco and alcohol, are not however, limited so ex- 
clusively to those who use them, but extend to inno- 
cent persons and abstainers therefrom, especially those 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 169 

of tobacco more directly by the vicious habit of smok- 
ing, which fills the air with a poisonous miasma that 
people are obliged to breathe and pollute their blood 
and bodies with, to their more or less serious injury, 
juch susceptible persons are not only thus directly 
sickened and enfeebled thereby, but rendered more 
than usually liable to the various contagious and 
epidemic diseases, as well as the ordinary afflictions of 
life. But, smokers diould not be allowed to thus 
outrage, endamage the health, and imperil the lives of 
others by inflicting upon them this deleterious tobacco 
smoke any more than the poisonous fames of chloro- 
form or other noxious substance. It is amazing that 
while so much effort is made to destroy other forms of 
malaria, this pernicious and all-pervading tobacco 
miasm is permitted to be engendered and diffused 
almost ad libitum everywhere, to the detriment of 
many persons, especially sickly and sensitive men, 
women, and children, who suffer greatly yet cannot 
escape therefrom. No other form of poisonous vapor 
would be allowed to be engendered and diffused so 
freely and indiscriminately as is the noxious fumes of 
tobacco, and as the world becomes sufficiently civilized 
it will be put under the ban of the law the same as 
other poisons. The infliction of tobacco smoke upon 
any one without special permission, will then, as it 
ought now, be treated as a criminal offense against 
personal right, and individual and public health, the 
same as the infliction of nicotia alone, or other baneful 
constituent of tobacco, and chloroform, prussic acid, 
opium, arsenic, and other poisons, either in solid, 
liquid, or gaseous form, is now justly treated as a 
crime. But, in the present state of barbarism in this 
respect, people must protect themselves with the young 



170 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

and helpless as best they can against these smoking 
poisoners and the congeries of potent poisons em- 
bodied in the vapor and smoke of tobacco, as they 
would defend themselves and others from any one of 
them, and all other pestiferous agents. Moreover, 
while endeavoring to stay the production and diffusion 
of this all pervading tobacco miasm, they must also 
adopt the best means to overcome its pernicious effects, 
both immediate and remote, as well as otherwise pro- 
tect against the inception of such destructive maladies 
as typhus, ship, yellow, bilious, enteric, puerperal, and 
other fevers, with diphtheria, erysipelas, cholera in all 
its forms, and all other toxemic, septic, infectious, 
scorbutic, and adynamic diseases serologically con- 
nected therewith, as well as decomposing organic 
matter, and specific contagia, with the noxious 
materials engendered within the body from its baneful 
action, vicious habits and bad modes of living generally. 

There is not only a natural endosepsis and exosepsis, 
but also a voluntary artificial autosepsis or self-poison- 
ing from the wilful ingestion of these noxious agents 
— tobacco and alcohol, as well as enforced involun- 
tary toxicosis, sickness, suffering, and death from the 
baneful miasm of the former engendered by smokers, 
all of which is unnecessary, inhuman, and avoidable 
by simple abstinence therefrom. 

Hence the vital necessity for personal with general 
sanitation, and especially for purity and depuration of 
the interior with the exterior of the body, as well as 
disinfection of clothing, ships, docks, houses, barracks, 
and other places, which are usually, though erroneously, 
considered all sufficient, for toxic, and contagious 
material may be spontaneously engendered within, as 
well as be introduced from outside the living organism, 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 171 

and be communicated to others, without the infected 
person or producer being sick, as manifested in 
vagrants, prisoners, nomads, pilgrims, and uncleanly 
people generally, particularly in hordes, crowded and 
close places, who by the offensive exhalations from 
their bodies, often infect others without being ill 
themselves, striking examples of which are afforded 
in the origin and spread of epidemics in the East and 
elsewhere, with other marked instances as in the Black 
Assizes of England, etc. The same condition of things 
exist in lower animals, as for instance, in the produc- 
tion and transmission pf the so-called Texas fever in 
cattle, and in the sickening emanations from pigs and 
other animals. Even cleanly persons may have their 
bodies charged with infectious and noxious matter 
sufficiently to transfer to others while unaffected them- 
selves, as is sometimes the case with the contagium 
of small-pox, scarlatina, diphtheria, puerperal fever, 
erysipelas, and other pestiferous and offensive agents, 
markedly with the effluvia of hospitals, dead-houses, and 
dissecting rooms, and the more common use of garlic, 
onions, tohacco, and alcoholic liquors, enough to 
sicken some who may be obliged to inhale the 
noxious and disgusting emanations from the lungs 
and bodies of persons surcharged therewith. A 
decided instance of the former is afforded in the gesta- 
tive woman who may have her blood so charged with 
the contagium of small-pox and other diseases as to 
infect her child in ittero without herself being affected, 
as shown in the birth of living as well as dead children 
with the disease. The foetus in utero is doubtless thus 
subject to all infectious and noxious agencies that may 
be absorbed into, as well as those produced within the 
mother's blood and body, while they may also with 



172 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

those engendered by herself, be given out freely 
enough to affect others. Indeed, it is most probable 
by some offensive emanation from a pregnant woman 
that causes the occasional so-called sympathetic sick- 
ness of stomach in the husband, similar to noxious 
exhalations in other cases which induce nausea, 
emesis, and more serious illness in many persons. 

Thus in the prevention of disease, especially of con- 
tagious and infectious maladies, while due attention 
should be given to general sanitation to remove or 
destroy all the extraneous sources thereof so far as 
possible, special effort must be made to disinfect, 
purify, and protect the human or animal body itself 
in its entirety, by internal as well as external depura- 
tion, for every organ, blood-corpuscle, cell, molecule, 
and particle of the economy must be freed and kept 
free from noxious matter to insure the greatest safety 
from intrinsic as well as extraneous morbific agencies. 
People must be taught as well as compelled to avoid 
the internal with the external causes of disease, to 
disinfect and depurate themselves, and purify every 
organ and atom of their bodies inside and outside, so 
as not to become factories of infection and veritable 
walking pestilences, sources of affliction, disease^ and 
death to others, which they have no more right to be, 
than to poison, infect, or destroy them outright. In 
general, this personal and systemic purity and protec- 
tion may be largely effected by abstinence from tobacco 
and spirituous liquors with all other deleterious 
agents and debasing habits, by correct modes of 
living, with appropriate alimentation, and especially 
the free use of acid drinks, fruits, and food, specified 
elsewhere, supplemented if necessary by the more 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 173 

active mineral acids, particularly the nitric, hydro- 
chloric, or nitro-hydrochloric, the most simple, agree- 
able, and potent disinfectants and antiseptics, that 
will neutralize the superalkalinity, and correct the 
scorbutic, toxic, septic, and infectious condition of the 
blood, refresh and purify the body, destroy contagious 
and morbific matter, with the parasitical microzymes 
and vermes, promote digestion, nutrition, secretion, 
and depuration, and invigorate the system in general. 
Phosphoric acid, coffee, allium, coca (Erythroxylon), 
quinia, oxygen with its analogues, and like antalkalies, 
stimulants, disinfectants, antiperiodics, and tonics, 
are also preventive as well as curative of asthenic 
fevers and conditions of system. Their permanent 
stimulant, protective, and remedial influence is in 
marked contrast with the morbid excitement and 
noxious effects of spirituous liquors of all kinds so 
much relied on for protective as well as curative 
purposes, but which really disorder the stomach, 
liver, nutrient and vital processes, fill the blood and 
body with impurities, depress the nervous and 
sy>temic energies, and induce as well as promote 
congestive, inflammatory, septic, infectious, and ady- 
namic diseases, especially in hot weather and climes, 
and during epidemics, hence should be entirely dis- 
carded. 

But, the most potent and essential agent of personal 
with general sanitation for the preservation and restora- 
tion of health under all circumstances, is an abundance 
of pure unadulterated atmospheric air, the most indis- 
pensable of all forms of food and tonics, supplemented 
when deficient by its active constituent — oxygen, or 
congeners — peroxide of hydrogen, and nitrous oxide. 
Oxygen, the active constituent of these compounds 



174 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

being the most powerful disinfectant and purifier in 
nature, as well as supporter of life- and promoter of 
health. Hence, without pure air, or its equivalent 
oxygen in an available form, it is of little use to resort 
to extraneous means of systemic disinfection, for they 
must all prove more or less nugatory in the absence of 
the most essential element of life, health, and purity — 
fresh, uncontaminated, vitalizing atmospheric air. Pure 
water is next in importance to atmospheric air as an 
aliment, diluent, depurant, invigorant, and restorative, 
essential for solution, circulation, nutrition, internal 
purification and expurgation, as well as external de- 
puration, which are powerful safeguards against infec- 
tious, epidemic, and septic maladies particularly, with 
fevers and diseases generally. 

Thus, premising a due supply of these essentia of 
life and health, to avert the occurrence and during 
the prevalence of typhus, ship, yellow, malarial, puer- 
peral, typhoid, and other fevers, with variola, scarla- 
tina, diphtheria, erysipelas, scurvy, cholera, and other 
zymotic, septic, infectious, and allied diseases, with 
general sanitation, special efforts should be made to 
disinfect and depurate the blood and bodies of seamen, 
travellers, soldiers, prisoners, pregnant women, chil- 
dren, and people generally, exposed or subject thereto. 
But this systemic purification should be actively from 
the interior as well as exterior of the body, and, while 
it may be induced by personal effort, could be most 
perfectly effected under medical supervision, by the 
free use of vegetal, animal, and mineral acids, with 
corresponding antalkalies, disinfectants, antiseptics, 
and alimentation, and other appropriate sanitation, in 
an abundance of pure air uncontaminated with the 
tobacco miasm or other form of malaria, and water 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 175 

free from impurities, with the usual personal and ex- 
traneous purification, especially in ships, quarantine, 
barracks, prisons, hospitals, and other places where 
authority prevails, though generally there would be 
little objection to the acid regimen and treatment, as 
the method is simple, safe, economical, agreeable, and 
efficient. Thus, with the other adjuncts, by the liberal 
administration of the mineral acids, the hydrochloric 
and nitric particularly, or better still the dilute nitro- 
hydrochloric acid in plain water or lemonade in the 
proportion of from x-xv njj to the juice of one lemon 
in a goblet of water sweetened to taste, and taken 
through a glass or other non-corrosive tube, every 
two or three hours, more or less frequently according 
to necessity, a marked disinfection of the blood and 
body may be soon effected. In conjunction therewith, 
acid drinks, fruit, and other food, with as much sugar 
as desired to reduce their sharpness and as an aliment 
and antiseptic, may be taken ad libitum, as the juice of 
limes, lemons, oranges, etc., with ripe tart apples, 
peaches, grapes, and other pulpy acid fruit that may 
be suitable, as likewise stewed apples, cherries, cran- 
berries, prunes, tomatoes, culinary rhubarb, and other 
appropriate acid vegetals as indicated. The stimulant 
and antiseptic juice of onions, garlic, and like articles 
of diet are also useful in the more atonic conditions 
of system. Sour buttermilk, cottage cheese, with 
or without sugar as fancied, soused pig's feet and other 
nitrogenized food acidulated with vinegar, or like com- 
patible acids as desired, may also be taken at pleasure, 
as likewise sauer kraut or its juice and similar anti- 
scorbutic articles so long as they are suitable and 
agree. For the milder scorbutic, and septic condi- 
tions of the system, the lime and lemon juice, with 



176 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

sour buttermilk, and the ordinary acid fruits and 
food, may be sufficient to neutralize the ammoniacal 
condition and superalkalinity of the blood, disinfect, 
and purify the body, and counteract the mephitic and 
infectious diathesis, without the stronger mineral acids, 
though these alone, or in conjunction therewith are 
so much the more decided, prompt, and efficient, and 
particularly applicable on ships, in quarantine, and 
times of danger. 

This acid alimentation and medication is usually 
very agreeable, and may be continued more or less 
freely until the scorbutic, superalkaline, mephitic, 
infectious, and pestiferous condition is entirely over- 
come, and the entire system disinfected and depu- 
rated, which is usually indicated by persons loosing 
the desire for acids which is generally active in such 
scorbutic, toxic, and infectious states of system, as 
well as by the marked change in the tongue, blood, 
and complexion, indicative of purification and health. 
Besides, further evidence is afforded by the disappear- 
ance of the jaundiced hue, and offensive exhalations 
from the lungs and skin with regularity or tendency 
to looseness of the bowels; bilious, muddled and 
dirty aspect, with torpid liver, offensive breath, foetid 
odor and constipation, being usual in such scorbutic, 
febrile, septic, and contagious conditions. In case, 
however, of exposure or tendency to typhoid fever, 
cholera, and similar disorders, with undue laxity of 
the bowels and diarrhoea, as before indicated, the more 
astringent disinfectants, acids, and remedies, with 
corresponding binding fruit juices, food, and general 
hygienic measures are most appropriate and useful. 

The basic pathogenic factor of cholera is an am- 
moniacal or superalkaline state of the fluids and solids 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 177 

of the system, the same as with all the other zymotic, 
infectious, and epidemic diseases, and may likewise 
originate at any time, anywhere, spontaneously, 
whenever the essential morbific conditions are 
present, or the excessive production, retention, or 
introduction of ammonia in the system with exosmotic 
action of the blood and bowels, such as heat, moisture, 
filth, close, confined, and poisoned air, with tobacco 
fumes or other malaria, the nicotian miasm itself 
being sufficient to induce, both as predisposing and 
exciting cause, all forms of choleraic clefluxions, as it 
surcharges the blood and body with ammonia, and 
other alkaline and toxic matters, enervates and de- 
presses the nervous and general system, diorders the 
stomach, liver, and bowels — causing dyspepsia and 
constipation, with alternations of diarrhoea, and nau- 
sea, vomiting, and purging, or cholera morbus, and 
doubtless also cholera infantum, with the most severe 
form of malignant cholera, independent of all micro- 
organisms or concomitant agencies, being in itself an 
active materies morbi and cause of intestinal defluxions 
w r ith other colliquative affections, and especially 
pernicious and energetic when a tendency thereto 
exists, even in those habituated to its use, and so 
much the more in those unaccustomed to it, with th e 
many who cannot endure its baneful effects at all, and 
are readily depressed, nauseated, sickened, vomited 
and purged, or afflicted with choleraic and other ady- 
namic disorders thereby. A most potent predisposing 
and exciting cause of all such choleraic and correlative 
scorbutic, zymotic, septic, infectious, and colliquative 
diseases, is thus in general use in the form of tobacco, 
while its pernicious miasmatic smoke is almost uni- 
versally engendered and diffused everywhere to the 



178 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

detriment of the innocent with the guilty, so that 
while seeking to discover and exterminate collateral 
malaria and morbific agencies, this omnipresent and 
powerful one should not be overlooked or disre- 
garded, but effectually extinguished or suppressed, at 
least so far as to protect the guiltless against its 
noxious influence. 

Though microbes may be found connected with 
cholera, it is not very probable they are the primal 
etiological factor of the disease, being rather merely 
concomitant or secondary products. As Dr. C. C. 
Vanderbeck justly observes [Medical Bulletin), " The 
weight of authority is against its being bacteria or 
microscopic life. Finding bacteria in cholera ejections 
does not prove them to be the cause of the disease, 
any more than finding skippers in cheese proves them 
to be the cause of cheese degeneration. We must 
not forget that dirt is favorite soil for low forms of 
organic life, and suitable food for disease germs, and 
that bacteria and disease germs may be, very likely 
are, different things, existing in the same suitable 
medium for their development. 

Now the basic element of dirt and pabulum for the 
development and support of microzoa is ammonia, and 
as a superalkaline condition of the system is the ser- 
ological substratum of cholera with all other cognate 
diseases, it is most probable that it is the primal and 
superinducing morbific factor thereof when in excess, 
without any specific poison or microzyme, but merely 
any general influence that will induce irritation, 
congestion, and defluxion in the bowels superadded 
as in ordinary diarrhoea. Thus, in fact, merely the 
ordinary causes of diarrhoea intensified, in conjunction 
with the ammoniacal and superalkaline dyscrasia, are 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 179 

doubtless sufficient to develop malignant cholera as 
well as cholera morbus, cholera infantum, and diar- 
rhoea, or different degrees of choleraic defluxion, as it 
often occurs sporadically in different parts of the 
world, and may become infectious and epidemic when 
this superalkaline predisposition exists in many per- 
sons to a sufficient degree for the secondary as well as 
primary development of the infecting principle and 
microzymes, which may then find lodgment in such 
suitable alkaline bodies and soils for propagation and 
activity, in the absence of which they would either be 
undeveloped, inert, or die out, the cholera or hsemic 
and intestinal flux being an active conservative pro- 
cess to rid the blood and bowels, and eliminate from 
the system, the excessive alkaline, poisonous, and 
infections, or irritant matter therein, though the ex- 
purgatorial action is apt to become so excessive as to 
seriously disorganize the blood, depress the vital 
energies, and often speedily destroy life, all of which 
may be prevented by subverting the basic superalka- 
linity and primal morbific cause of this with allied 
diseases by acidulous and antalkaline alimentation 
and medication, and correct modes of living. 

The alkaline basis of cholera has been recognized, 
but apparently merely in a general way, the more 
specific causative influence of the volatile organic 
alkali — Ammonia — being overlooked as the prime 
underlying morbific factor and direct basic pabulum 
vit;e for the development and activity of the infecting 
poison and microzymes or secondary pathogenic 
agencies thereof with correlative diseases. 

Thus, recently among other conclusions from a 
study of "a vast mass of accumulative evidence" 
upon the subject, Dr. Frank W. Reilly, while he 



180 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

admits and limits the spontaneous origin of the 
cholera poison and disease to India "only," though it 
is obvious they may develop anywhere whenever the 
essential factors therefor are present and as proven by 
the occasional occurrence de novo of sporadic and 
epidemic cholera in different parts of the world, says 
in a report to the Surgeon-General of the U. S. Marine 
Hospital Service (Jour. Amer. Med. Assoc, Sept. 22, 
1883) : " To set up anew the action of the poison 
alkaline moisture and a decomposing temperature are 
required, fluid of decided alkaline reaction hastening 
the process, the reverse retarding. Favorable con- 
ditions for the growth of the poison are presented (1), 
in ordinary water containing nitrogenous organic 
impurities, alkaline carbonates, etc.; (2) in decompos- 
ing animal and vegetable matter with an alkaline 
reaction ; (3) in the alkaline contents of the intestinal 
portion of the alimentary canal. 

" A cholera ejection, or material containing such, is 
harmless, both before the appearance and after the 
disappearance of bacteria, but is actively poisonous 
during their presence." Yet this may be in conse- 
quence of the presence of their ammoniacal pabulum 
and toxic concomitant, in the absence of which they 
are undeveloped, or starve. 

u The poison is destroyed naturally either by the 
process of growth or by contact with acids; (1) in 
water or soil ; (2) acid gases in the atmosphere ; (3) 
the acid secretion of the stomach. 

" It may be destroyed artificially (1) by treating the 
cholera ejections or material with acids; (2) by such 
acid (gaseous) treatment of contaminated atmosphere; 
(3) by establishing an acid diathesis of the system." 
From these propositions he is convinced " that the 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 181 

mineral acids may be relied upon as a certain means of 
preventing the spread of Asiatic cholera." 

In reviewing the subject Dr. Vanderbeck remarks 
(ante): " For the purpose of disinfection, nitrous-acid 
fumes and burning sulphur are indicated. As to the 
acid medication, it has received the indorsement of all 
the best observers and practitioners having experience 
in cholera epidemics. It is particularly insisted upon 
as a preventive. If the disease should break out on 
^hip-board, besides isolating the patient, and acidulat- 
ing all his discharges and surroundings, the crew and 
passengers should be placed on sulphuric acid lemon- 
ade. This rule can be applied to army hygiene, and 
to city and dwelling sanitation." It is also of universal 
application in personal and public sanitation. 

With other sanitarians the same writer enforces the 
necessity for cleanliness. "With many diseases dirt 
seems to favor the vitality of their germs and it is 
without the shadow of a doubt the case in the disease 
under consideration. What is the inevitable conclu- 
sion then ? to starve out the poison is to be clean — 
cleanliness in the strictest sense, clean persons and 
clothing, clean houses, cellars, and drains, clean sewers, 
streets and rivers, clean food and drink. Cleanliness, 
ever the sheet anchor of hygiene, is preeminently so 
in cholera seasons and epidemics." 

Moreover, not only to subvert cholera, but all other 
pestilential as well as ordinary innocuous disease, is 
cleanliness of primal and supreme importance, and 
above all clean air and purity of the blood and body, 
or personal sanitation in its entirety. Yet, how can 
this be secured when the air is freely contaminated 
with the noxious tobacco miasm that so actively alka- 
lizes and poisons the fluids and tissues of the living 



182 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

economy, depresses the nervous and vital energies, 
promotes mal-nutrition, ansematosis, corrupt meta- 
morphosis, and toxic condition of the system, with 
purpuric, hemorrhagic, serous, and intestinal fluxes, 
and specially predisposes to, and excites disorder of 
the stomach, liver, and bowels, diarrhoea, cholera 
morbus, cholera infantum, and malignant cholera, with 
other pernicious maladies, as well as many minor ab- 
normities. Hence, it is vitally important to discard 
and avoid this poisonous tobacco miasm with all other 
forms of malaria and toxic agencies, or causes of 
diseases, while to counteract the superalkalinity of the 
system and tendency to cholera with allied intestinal 
and other affections, astringent and tonic acids with 
corresponding neutralizing, disinfecting corroborants 
and regimen are required. 

Thus, it is apparent that an ammoniacal and alka- 
line dyscrasia develops the pathogenic causes and 
microbes of cholera with other diseases. Even for the 
support of the claimed cholera bacillus, Koch found 
that it requires an alkaline medium, and is readily 
destroyed by heat, dryness, and acids. But, it has 
been ascertained that the so-called comma-bacillus is 
not peculiar to cholera at all, or even to disease, as a 
similar or indistinguishable spirillum exists in the 
mouths of healthy people. Thus it is stated by Dr. 
H. Raymond Rogers {Jour. Amer. Med. Assoc, Oct. 18, 
1884) that the so-called cholera microbe of Koch is 
now found where cholera does not exist, and, too, as Dr. 
Koch informs us, in other epidemic diseases. All diag- 
nostic or therapeutic significance is removed from this 
microscopic object. a Besides, Surgeon Major Timo- 
thy Richard Lewis, M. B., Assistant Prof, of Pathology 
in the Army Med. School (Netley), states in the 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 183 

Lancet, Sept. 20, that comma-like bacilli identical in 
size, form, and in their reactions with aniline dyes, 
with those found in choleraic dejections, are ordinarily 
present in the mouths of perfectly healthy persons." 

From his experiments on animals, which are detailed 
in the Indian Med. Gaz., April, 1884, the Lancet states, 
(Jour. Amer. Med. Assoc), that Mr. Vincent Richards 
found that " Decomposing choleraic discharges had no 
effect on pigs, but as in other instances, the administra- 
tion of recently-passed stools proved more or less 
rapidly fatal, with symptoms of asphyxia. Mr. Richards 
concludes that the alvine discharges at certain stages 
of cholera contains a powerful poison, whose chief 
action is to enfeeble and destroy the function of 
respiration. The rapidity of its action excludes it 
from being an organism, and he thinks that it is a 
chemical compound, probably of albuminoid nature. 
It remains for chemistry to isolate the body, and for 
experiment to determine accurately its physiological 
action; but Mr. Richards thinks that it will probably 
be found to be easy to disinfect the evacuations by 
permanganate of potash." 

It is thus most probable that the contagia of cholera 
with all correlative affections are of a specific chemico- 
organic nature evolved from nitrogenous and ammo- 
niacal matter both within and without the vital 
economy, and partaking of the character of the toxic 
ptomaines, which may be engendered or introduced 
in the circulation and gastro-intestinal canal, the 
choleraic tendency being apparently superinduced by 
some poisonous agent in the blood as well as bowels. 
Hence this cholera poison may be of the same nature 
as the toxic ptomaines, which Prof. R. N. Wolfenden 
says (Ibid) "are developed in the body, post-mortem," 



184 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

and which are of "an alkaloidal character, and can be 
obtained also by decomposition of albumen, peptone, 
casein, muscle, brain, etc. Moreover they seem to be 
present in some normal secretions (saliva and urine). 
Probably the production of ptomaines within the living 
body may be the pathological cause of many obscure 
conditions, especially those following on poisoning by 
bad blood, such as stale fish, etc." 

Stale and tainted meat, fish, shell-fish, and other 
decayed food, are very apt to cause gastro-enteric 
disorder with vomiting and purging, cholera morbus, 
diarrhoea, or choleraic and other affections, which may 
be dependent upon such occult poisons, as well as 
their indigestible character. 

They may doubtless also be introduced through the 
lungs, as these poisonous alkaloidal ptomaines are 
volatile and allied with ammonia, and are neutralized 
and destroyed by acids, for according to the same 
authority " they are often amorphous in form and 
alkaline in reaction, for the most part volatile and 
easily alterable, forming chrystalline salts with acids 
as a rule. The addition of acids to them usually 
changes them, with the production of pleasant odors 
like orange flower, musk, etc., allowed to oxidize by 
contact with atmospheric air, they emit disagreeable 
cadaveric or urinous odors." As they originate from 
nitrogenous and ammoniacal matter, they may be 
re-converted into ammonia and like it volatilize and 
decompose when exposed. 

Furthermore, as bearing upon this subject, Dr. G. 
V. Black, of Jacksonville, 111., has presented the in- 
genious view {Jour. Amer. Med. Assoc, Sept. 13, 
1883), that microphytes develop poisonous morbific 
matter like mushrooms and other macroscopic plants, 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 185 

thus, " pathogenic micro-organisms by their re-molecu- 
lization of matter, form poisons of the nature of the 
alkaloids, which are the active agents in the produc- 
tion of disease." But, for this purpose these 
microbes must have nitrogenized matter of which the 
elements of ammonia are the basis, hence both 
directly and indirectly, micro-organisms, toxic pto- 
maines, contagia, septic, and other poisonous prin- 
ciples, are all dependent upon ammonia as the basic 
forts et origo mall, whenever it is sufficiently abundant 
to supply the necessary pabulum, and stimulus for 
their spontaneous or secondary development and 
transmission. 

Thus, with all other zymotic and infectious diseases, 
whether cholera is dependent upon an ammoniacal or 
superalkaline state of the blood, gastro-intestinal 
canal, and general system, a specific contagium, toxic 
ptomaine, organic or chemical poison, or special 
bacillus, or all together, as they are apparently in- 
timately connected, the basic and specific acid and 
antalkaline treatment is indicated and has empirically 
proven most efficient both for prophylactive and 
curative purposes therein. Hence, in cholera and 
like gastro-intestinal disorders, astringent acidulous 
drinks and medicanlents are thus most effective, 
especially phosphoric acid and its compounds of iron 
and lime, and plain or aromatic sulphuric acid, which 
is one of the most useful both. chemically and clinic- 
ally as an antalkaline, astringent, germicide, antisep- 
tic, and tonic. This, with other acids being destruc- 
tive of microzymes and subversive of their basic 
pabulum — ammonia, and its toxic concomitants, as 
well as counteractive of their morbific effects. It is 
especially corrective of choleraic affections and has 



186 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

been employed to purify the drinking water particu- 
larly, but also exerts a beneficial antidotal, detergent, 
and protective effect upon the system. For instance, 
as stated {Philadelphia Ledger) this was put in use at 
the Philadelphia Gas Works in 1849, by direction of 
Dr. C. M. Cresson. The workmen employed at the 
Gas Works were directed to add to each pint of 
Schuylkill water one or two drops of sulphuric acid, 
which was furnished them for the purpose. " So far 
as my knowledge goes,' 5 Dr. Cresson says, in a pam- 
phlet on Drinking Water, published in 1875, "and I 
was constantly at the Gas Works during that summer, 
not a single case of cholera occurred among them, 
although the employment, location, and habits of the 
men predisposed them and favored an attack of the 
epidemic, of which they were in the midst." 

Plain or aromatic sulphuric acid may often be ad- 
vantageously added in appropriate doses, to common 
tea, without milk, duly sweetened. Tea alone being 
an exhilarating and constipating beverage, and with 
the acid forms a pleasant antalkaline, antizymotic, 
antitoxic, astringent, and tonic drink, acceptable to 
children as well as adults, that may be taken more or 
less freely according to desire and necessity, with due 
regard to the protection of the teeth, both for 
preventive and curative purposes in diarrhoea, cholera 
infantum, cholera, and other gastro-intestinal defluxi- 
ons, serous, hemorrhagic, catarrhal, or purulent, as in 
typhoid fever, dysentery, enteric and other profluvia 
of phthisis, with analogous fluxes from the genito- 
urinary and other organs. When a more stimulant 
effect is required phosphoric acid and its compounds 
of iron and lime are applicable, with other constring- 
ing tonics as indicated, where there is a tendency to 
looseness of the bowels, or diarrhoea and cholerine. 



DIPHTHEKIA, TYPHOID, AND ALLIED DISEASES. 187 

Vinegar is also a useful astringent acid, antalkaline, 
germicide, antiseptic, diuretic, and sanitive, applicable 
both as a preventive with the food and drink, and 
remedy in choleraic defluxious. In sweetened, plain, 
barley, or other water it forms a pleasant, antalkaline, 
and prophylactive drink, and as a condiment with the 
food aids digestion, and promotes normal action of the 
stomach, liver, and bowels. As a remedy for diarrhoea 
it is said to be quite efficient by Dr. T. E. Stellwagen, 
[Med. and Surg. Reporter) in the form of cider vinegar 
preferably, in the dose of about two ounces undiluted 
for an adult. It may also be given to infants, in the 
dose of a teaspoonful of moderately diluted vinegar to 
a babe a year old. " Its effect is to check pain, tenes- 
mus, and tormina, at once, to relieve the chilliness and 
cramps, when present, and to disseminate a feeling of 
warmth and comfort over the body." Hence may 
prove restorative as well as preventive in cholera. 
Aromatic, and camphorated vinegar are also indicated 
therein. Dilute acetic acid or perhaps better its im- 
pure form of pyroligneous acid, as it contains creosote, 
with carbolic acid and its analogues, will doubtless 
prove useful in cholera with other gastro-intestinal 
fluxes and disorders of the alimentary canal and general 
system. In general, astringent acids particularly, are 
very efficient in scorbutic, superalkaline, and bilious 
diarrhoeas. 

For the active flow of diarrhoea and choleraic fluxes 
with collateral states, I have found the following 
very efficacious in arresting the profluvia and correct- 
ing the intestinal disorder: Plumb, acetas, gr. iss, 
camphor gr. j, opium and carbolic acid (cryst.) each 
one quarter of a grain, combined in one pill, (to which 
may be added calomel, if desired,) and taken every 



188 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

hour or more or less frequently according to necessity, 
with sometimes in conjunction therewith a suppository 
of three grs. of acetate of lead to one half gr. of 
opium combined with five or more grs. of cacao 
butter, introduced into the rectum after each discharge 
until it is checked, yet, if used too freely they will 
contract the bowels unduly, and produce discomfort 
and general sedation. 

To prevent and overcome the depression and other 
concomitants of gastro-intestinal fluxes, with choleraic 
and allied affections the more or less free voluntary 
inhalation of the oil of turpentine is also very useful 
in connection therewith. It is highly probable that 
in cholera, as well as other depressed conditions, the 
active inhalation of the oil of turpentine will be 
decidedly efficient, as it thus directly enters the blood, 
acts promptly and generally as a potent stimulant to 
the heart, circulation, and nervous system, subverts 
congestion, disorganization, and effusion of the serum 
of the blood, promotes the secretions and especially of 
the skin and kidneys usually suppressed in that dis- 
ease, increases the heat, tendency to the surface, and 
energy of the body, and will doubtless act effectively 
in creating a diversion from the gastro-intestinal 
canal, counteracting the systemic depression, torpor, 
and typhoid tendency, and rousing a sufficient degree 
of vital power to excite reaction and overcome the 
disease altogether, though of course, it may be ex- 
hibited by the mouth and rectum, as well as by 
external application directly and in hot baths, and be 
aided by other appropriate remedies. 

" In Cholera, the Spirit of Turpentine applied by 
means of hot flannels, and by diligent friction over 
the abdomen, is one of the best external applications 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 189 

which can be resorted to. It may also be administered 
in the form of enema; thus employed it has proved in 
many instances highly serviceable, stimulating the 
system, allaying the vomiting, and causing a degree 
of reaction which other remedies fail to produce. I 
would also strongly advise its internal exhibition in 
the manner and doses advised in haemorrhage. In the 
stage of collapse, its external application should never 
be neglected." — (Waring 9 s PracL Thera.) 

Nitrous oxide is also strongly indicated both for 
preventive and curative purposes in cholera as in 
allied abnormities, to preserve and restore the in- 
tegrity of the blood, oxygenation, haematosis, calori- 
faction, and circulation, increase the tonicity of the 
heart, nervous and muscular system, subvert abnormal 
defluxion from the blood and bowels, promote normal 
secretion of the liver and kidneys especially, and 
stimulate and invigorate all the functions of life. It 
will no doubt prove as actively efficient as an exhilar- 
ant, tonic, revivifier, reactive and restorative in 
cholera, as in correlative depressed and collapsed 
conditions, and adynamic diseases, given in frequent 
small and stimulant doses and continued so long as 
required. Oxygen is likewise useful for the same 
purposes, but is not so stimulant and active as nitrous 
oxide. Peroxide of hydrogen will doubtless also 
prove useful in cholera with cognate diseases. 

These more purely physiological means of protec- 
tion and restoration in cholera with all correlative 
diseases are especially indicated therein, as they are 
potent disinfectants, stimulants, resolvents, tonics, and 
restoratives, of general application, with appropriate 
alimentation, also of prime importance. Thus, for 
instance, in gastro-enteric affections particularly as 



190 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

typhoid fever, cholera, diarrhceal, and similar disorders, 
such acidulous, astringent and constipating fruit juices, 
jellies, and food, as oranges, peaches, bananas, per- 
simmons, quince, blackberry, and like acid and con- 
stringent vegetals, with gum arabic, rice, barley, etc., 
in infusion and more consistent form, strong tea 
plain or acidulated, and still better milk, usually hot 
and peptonized, though it may be taken at any 
temperature desired, with lime water or sulphite of 
lime, bicarbonate or bisulphite of soda, in small 
quantities at a time, and other albuminous and amyla- 
ceous diet of a binding nature, are best, laxative fruit, 
food, and other substances being contraindicated in 
such intestinal. profluvia. 

Wearing a thick flannel bandage around the abdo- 
men, or better, warm woolen underclothing is pre- 
ventive and corrective of diarrhoea and choleraic deflux- 
ions, during the existence of which a recumbent position 
is all important, the upright position being dangerous 
and sometimes causing sudden death. In the collapsed 
state of cholera elevating the lower part of the body so 
as by gravitation to increase the quantity of blood and 
stimulus to the heart and brain, is recommended by 
Dr. H. Kaymond Rogers, of Dunkirk, N. Y. As the 
inverted position with the head lower than the body 
and limbs, is so very useful in depression from anaes- 
thesia, haemorrhage, and otherwise, it will doubtless 
prove beneficial in the collapse of cholera with all 
other forms of syncope. Artificial heat to preserve 
and restore the normal temperature of the body is also 
often necessary by warm dry air, hot and stimulant 
applications to the surface, massage, etc. 

In the preventive and restorative treatment of 
cholera with allied zymotic, septic, and infectious 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 191 

maladies, the more volatile antalkalies, acids, disin- 
fectants, and germicides, as chlorine, phenic, sulphur- 
ous, and sulpho-carbolic acid, with thymol, eucalyptus, 
and other essential oils are also applicable both 
internally and externally. They may be readily 
diffused in the air and thus more or less freely inhaled 
as potent antiseptics, counteractives, depurants, and 
destroyers of both extraneous and internal microzy- 
mes, alkaline, toxic, and infectious matter. The 
diffusion of turpentine with other essential oils in the 
air, will also engender ozone, a most powerful disin- 
fectant, germicide, and nullifier of noxious and con- 
tagious principles. 

With the internal oxygenation, antisepsis, and de- 
puration, external disinfection and purification of the 
surface of the body is also important in all cases and 
times, by the usual bathing in fresh, or often better, 
medicated water, as sponging or baths of salt or sea- 
water, solutions of the various mineral and vegetal 
acids, and other agents as chlorine, chlorinated, or 
sulpho-carbolate of soda, tar, turpentine, etc., properly 
diluted. 

This basic acid and antalkaline medication and 
regimen with their allied agencies are thus applicable 
in the prevention and treatment of yellow fever and 
cholera as in ship, typhus, remittent and malarious, 
bilious, enteric, puerperal, scarlet, and other fevers, 
with small-pox, diphtheria, measles, erysipelas, car- 
bunculoid, gangrenous, and mephitic conditions 
generally, they being very efficient in all such 
zymotic, septic, infectious, scorbutic, and putrescent 
diseases according to my experience with that of 
others previously indicated, and will doubtless prove 
as specific in the former as in the latter, when properly 



192 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

adapted thereto, for while in general, this acid and 
antalkaline treatment is basic and specific in all such 
maladies, as before noted, it requires to be modified 
and supplemented to meet the varied indications in 
the special phazes and complications of these am- 
moniacal, superalkaline, infectious and malignant 
diseases, in accordance with their specific character, 
morbid manifestations, and complexities, without, 
however, changing its fundamental nature and appli- 
cations thereto. 

Thus, by the general adoption of the sanitary and 
medicinal measures herein presented for preventing 
and destroying the immediate personal as well as re- 
mote causes — internal and extraneous, and counter- 
acting the active basic predisposing and exciting 
ammoniacal, superalkaline, and concomitant toxic, 
malignant, and microbic conditions of all z} T motic, 
septic, contagious, pestilential, putrescent, and ady- 
namic diseases, much unnecessary sickness, suffering, 
and sacrifice of life, with their concomitant evils 
throughout the world may be prevented, w T hile 
individual and public health will be promoted, and 
human energy, activity, happiness, prosperity, pro- 
gress, and civilization, proportionately increased. 
But to this desirable end every one must be self- 
helpful by avoiding all deleterious agents and vicious 
habits, and by continuous and adequate disinfection 
of their entire system — inside and outside — so as to 
depurate and purify most effectually every blood-cor- 
puscle, cell, part and particle of their bodies, as well 
as to preserve the purity of the air they breathe, the 
water they drink, the food and other ingesta they 
take, with clothing, ships, habitations, and surround- 
ings generally. Thus by correct modes of living, 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 193 

appropriate alimentation, aeration or oxygenation and 
purification of their own bodies and environments, 
people can largely protect themselves from these 
destructive scorbutic, contagious, epidemic, malig- 
nant, and mortiferous diseases with the minor ills of 
life, and realize most fully the truth of the old Saler- 
nian oracle that he 

<l Who guards his health, his life in turn makes sure, 
Prevention far surpasses any cure." 

Ondroneaux's Trans. Exhortatio Sanitalis. 



194 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

VI. 

CONCLUSIONS. 

Having thus presented a very general outline of the 
basic aetiology, pathology, and treatment — both pre- 
ventive and curative, of typhus, ship, yellow, remittent, 
bilious, puerperal, enteric, and other fevers, with 
cholera, diphtheria, scarlatina, small-pox, purpura, 
scurvy, erysipelas, gangrenous, carbunculoid, and scor- 
butic, zymotic, septic, infectious, pestilential, malarial, 
mephitic, putrescent, and cognate diseases generally — 
the most virulent maladies that afflict and destroy 
mankind and the lower creatures, for a more specific 
and systematic exposition of the subject I add the 
following summary of my conclusions thereon. 

I. That the living organism is composed of various 
chemical elements, prominent among which are the 
fixed alkaline bases and metals, — calcium, sodium, and 
potassium, an excess or deficiency of which results in 
abnormal states or disease that is variously manifested 
and complicated. 

II. That, besides the metallic oxides or fixed alkalies 
— calcia, soda, and potassa, which are always introduced 
from without the body in various forms and combina- 
tions, there is another prominent alkali — Ammonia, 
differing materially from the others in being unstable, 
volatile, and organic, that is both engendered within 
and introduced from without the living organism. 

III. That, in excess in the -vital economy, these 
alkaline substances induce various abnormal condi- 
tions primarily manifested in a morbid crasis or dys- 
crasia of the blood and body, which for brevity and 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 195 

convenience may be termed in general, superalkalcemia, 
of which there are several varieties corresponding to 
the special alkalies, that may be respectively designated 
thus, from an excess of lime — Calccemia; of sodium — 
Nalricemia ; of potassium — Kalicemia in conformity 
with that of ammonia — Ammonce?nia, and others of a 
like tenor. 

IV. That, each one of these forms of superalka- 
laemia, though with the same general basis of superal- 
kalinity, is attended with distinctive constitutional and 
local manifestations and complications of disease, as 
of lime or Calcemia, in diminished secretion, consoli- 
dation of tissue, calcariou3 and osseous degeneration; 
of sodium and Natriremia, in concretions and arthritic 
deposits of urate of soda or chalk stones, with second- 
ary inflammation and neuroses, as in gout, etc., though 
sodium is primarily liquefacient and scorbutic but 
not to the same degree, as potassium in excess, or 
Kaliaemia, which causes solution and increased fluidity, 
with degeneration, and passive defluxion of the blood, 
and scurvy, purpura, and similar disorders of a non- 
febrile and non-inflammatory character but disorganiz- 
ing and asthenic tendency. While an excess of 
ammonia or Ammon8emia,also induces undue solvency, 
fluidity, and scorbutic deterioration of blood with a 
disposition to active serous, hemorrhagic, febrile, in- 
flammatory, and dissolutive conditions, both general 
and local, of a toxic, septic, contagious and primal 
sthenic, but ultimate and general adynamic type. 

V. That, these respective dyscrasia may be produced 
at will by the free administration of these alkalies, 
and are often induced fortuitously in the over-indul- 
gence of ingesta containing them, as impure water 
with ammoniacal or organic contaminations, and 



196 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

saline waters, liquors, and food, with much lime, soda, 
and potash, as in mineral waters, wine, salted meat, 
with tobacco in its various forms, as well as the undue 
use of the former medicinally, and all of which may 
be variously combined, thus giving rise to diverse and 
complex forms of disease — acute and chronic, of 
various types and degrees of intensity, though of a 
general asthenic character. 

VI. That the most noxious of these alkalies are 
potassa and ammonia, which though in general 
similar in their basic acrid and liquefacient action 
upon the blood and tissues, differ widely in their 
special effects and morbific manifestations on the 
system. Potash being solvent and sedative, in excess, 
depressing to the heart, circulation, nervous, muscu- 
lar, and general system, hence induces passive necree- 
mia, congestions, haemorrhages, defluxions, disorgani- 
zation, and enervation, with corresponding diseases of 
a low grade, as scorbutic and purpuric affections 
without much if any, fever or excitement. While 
Ammonia with like solvent effects upon the blood 
and tissues is stimulant, in excess, irritant, inflamma- 
tory, disorganizing, and prostrating, exciting, and 
irritating the heart, blood-vessels, circulation, organs 
and system generally, hence causes active congestions, 
serous effusions, haemorrhages, inflammations, fevers, 
and defluxions of every variety and degree, with a 
mixed form of sthenic and asthenic disease, the latter 
preponderating from its diffluent and disorganizing 
effects upon the fluids and solids of the body. The 
baneful action of both these alkalies are often com- 
bined from bad habits and modes of living, as well 
as accidentally, with corresponding complexity of 
disease. 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 197 

VII. That, while the fixed alkalies are introduced 
only from without the body exclusively in the ingesta, 
Ammonia being an organic volatile alkali formed by 
the direct union of its gaseous constituents in the 
normal chemico-organic reactions of the elements of 
the body is largely generated and retained within the 
vital economy as well as more or less freely introduced 
from without the system, especially in such noxious 
ingesta as tobacco with its vapor and smoke, impure 
water and air or malaria from extraneous decomposing 
and other matter, or even by its re-inspiration after 
exhalation in close places. Hence ammonia is more 
apt to accrue in excess within the body and rapidly 
and frequently cause disease than other alkalies, 
particularly in hot weather, seasons, and climates, or 
undue exposure to artificial heat, both dry and with 
moisture, and periods of overactivity of system, impure 
air in confined places, defective alimentation, and bad 
habits and modes of living at any time and place. 

VIII. That when Ammonia accumulates to a cer- 
tain extent in the body, whether from undue chemico- 
organic evolution or retention within, or extraneous 
introduction from without the economy, or all 
together, it causes a diffluent disorganizing, and 
pyrexial condition of the blood and tissues, with 
a scorbutic, toxic, necrsemic, phlegmonous, febrile, 
pyemic, septic, infectious, mephitic, and colliquative 
state of system in various degrees of intensity and 
activity, excites with minor disorders, congestive and 
inflammatory action in different organs and parts of the 
body with fever of a stheno-asthenic type as mani- 
fested in various eruptions, anthrax and carbunculoid 
affections, serous, albuminous, and hemorrhagic de- 
fluxions, as anasarca, diarrhoea, cholera, albuminuria, 



198 BASIC PATHOLOGY AND SPECIFIC TKEATMENT OF 

leucorrhcea, bronchorrhoea, epistaxis, haemoptysis, 
hematuria, haematemesis, and haemorrhage from the 
gums, bronchia, bowels, uterus, ami skin, and into 
the internal tissues with apoplexies of lungs, brain, 
and other parts, or scurvy, purpuric, haemorrheal, 
purulent, and colliquative diathesis, and such abnormi- 
ties as lithaemia, uraemia, erysipelas, diphtheria, in- 
flammation of stomach, liver, and other organs, with 
gastric, bilious, remittent, puerperal, enteric, and the 
more malignant congestive, typhus, ship, yellowy and 
allied fevers, with typhoid, contagious, mephitic, 
pestilential, and scorbutic diseases generally, all of 
which result more or less speedily and intensely from 
heat, moisture, filth, impure air and water, with other 
baneful ingesta and conditions that largely increase 
the evolution, retention, and increment of ammonia 
within the vital economy, especially in close and 
crowded places, as strikingly exemplified in the rapid 
development of ammonaemia, septicaemia, and conta- 
gium in the surviving prisoners of the infamous 
" Black Hole of Calcutta," who after escaping speedy 
death from suffocation, were immediately attacked 
with a malignant typhus fever. Besides the property 
of ammonia to induce a scorbutic, solvent, and 
necraemic condition of the blood and typhoid state 
has been observed by many and experimentally 
demonstrated by its artificial introduction into the 
animal system by forced inhalation and swallowing 
by Dr. B. W. Richardson. — {Waring' 's PracL Thera.) 

IX. That, Ammonia is the basic agent and principal 
morbific factor of all the varied scorbutic, zymotic, 
septic, infectious, necraemic, pestilential, and putres- 
cent maladies, with mephitic, choleraic, and cognate 
diseases in general, local as well as systemic, its 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 199 

resultant ammonaemia and concomitant purpuric, 
typhoheemic, and septicemic dyscraia, being the sole 
cause of many, and the underlying chemico-toxic 
condition upon which the infecting principle and 
malignancy of all depends, from the slightest ab- 
normity to the most contagious malady, in every 
degree of activity, intensity, and complication, 
according to its quantity, rapidity of evolution, reten- 
tion, and susceptibility to its noxious influence, 
abnormal tendencies, and concurring morbific agencies 
of heat, moisture, malaria, contagia, climate, weather, 
exposure, defective dietary, bad habits and modes of 
living. 

X. That, besides the natural internal systemic and 
extraneous sources thereof from organic transforma- 
tion and decomposition Ammonia is largely artificially 
engendered and introduced into the body in the per- 
nicious juice, vapor and smoke of tobacco with its 
other noxious ingredients, which produce a special 
form of blood-poisoning and toxicosis from the 
separate and combined action of its baneful constitu- 
ents that are both of an irritant and depressing or 
acro-narcotic character, thus causing and helping to 
induce a superalkaline, toxic, and perverted condition 
of the fluids and solids of the economy, with general 
inanition and adynamia, productive and promotive of 
scorbutic, purpuric, necrsemic, septic, mephitic, infec- 
tious, and other corrupt and asthenic states of system, 

XL That, in general, in various ways, chemically 
by adding ammonia, nicotia, and other noxious 
matter to, alkalizing, poisoning, preventing the oxy- 
genation, and polluting the blood, irritating the lips, 
mouth, throat, air-passages, lungs, heart, and genito- 
urinary organs, debilitating the gastro-intestinal canal 



200 BASIC PATHOLOGY AND SPECIFIC TREATMENT OP 

and chylopoietic viscera; and, dynamically depres- 
sing the brain, nervous, muscular, and general system, 
tobacco disorders every organ and function of the 
economy, and acts as a powerful predisposing and 
exciting cause of local and constitutional, physical 
and mental disease, as manifested in ptyalism, can- 
cerous affections of lip, tongue, and nares, ulcerations 
of mouth and throat, diphtheria, cynanche maligna, 
laryngeal and pulmonary phthisis, dyspepsia, torpid 
liver and bowels, biliousness, piles, nausea and vomit- 
ing, constipation and diarrhoea alternately, cholera 
morbus, cholera infantum, and doubtless also malig- 
nant cholera, mal-nutrition, marasmus, mal-disinte- 
gration, neuralgia and paralysis of face and heart, 
angina pectoris, adynamia of brain and nervous 
system, neurasthenia, melancholy, insanity, dementia, 
blindness, deafness, and paralysis of ganglionic and 
sensori-motor functions generally, with bronchorrhcea, 
leucorrhcea, albuminuria, and Bright's disease, abnor- 
mal production and retention of excrementitious 
matters in the system, toxaemia, lithaemia, uraemia, 
superalkalaemia, and scorbutic condition of the blood, 
promotive of purpura, typhus, ship, yellow, congestive, 
puerperal, enteric, and other asthenic fevers, with 
haernaturia, haemoptysis, haematemesis, and hemor- 
rhagic, septic, mephitic, choleraic, infectious, and 
adynamic affections generally, particularly when there 
is a special epidemic tendency thereto. 

XII. That, tobacco is particularly dangerous to 
sickly and sensitive people, children, and pregnant 
women, as it induces and intensifies both organic and 
functional diseases and tends to entail a degenerate 
organism upon children of nicotized parents, as well 
as to destroy them before and after birth, for the vapor 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 201 

and smoke of tobacco directly enters the blood of 
pregnant and nursing women as of others, and causes 
uraemia, sickness of stomach, miscarriage, uterine 
haemorrhage, puerperal eclampsia and fever, with 
other abnormities, as seen in the maladies and fre- 
quent abortions, and post partum sickness and death 
of the offspring of women who work in tobacco 
factories. Besides, how can children whose bodies 
are charged with this potent, tobacco poison both 
before and after birth from their mother's nicotized 
blood and milk, as well as directly from nicotized air, 
be properly organized or live, and normally develop 
when exposed to such a noxious agent that sickens 
and destroys adult human beings with the lower forms 
of life? Would pregnant or nursing cows with their 
calves be thus exposed to the pernicious fumes of this 
powerful poison, and are human beings of less im- 
portance than cattle? 

XIII. That, thus in various modes, tobacco pro- 
duces functional and organic, hereditary and acquired, 
acute and chronic asthenic diseases of the blood and 
body, undermines both physical and mental health, de- 
stroys the tone and stamina of body and mind, and 
saps the very foundations of life, inducing a state of 
toxicosis or Nicotism analogous to alcoholism, and 
often of itself suddenly as well as slowly terminates 
the existence of those who use or are exposed to it, 
there being little doubt but that some at least, of the 
many sudden deaths attributed to rheumatism, disease 
or paralysis of the heart, syncope, apoplexy, palsy, 
collapse, etc., are the direct result of nicotism, of the 
heart, blood, brain, nervous and general system, and 
either slow or speedy, a species of suicide or homicide, 
or both, according to whether inflicted upon self alone 
.i 



202 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

or others combined, hence the use of this potent 
poison should be entirely discarded. 

XIV. That, nicotism of the heart, stomach, kidneys, 
brain, nervous, and general system, with its concomi- 
tant nicotaemia and general extraneous sources of 
alkaline, poisonous, and depressing agents inhaled 
and otherwise ingested in the body, superadded to the 
internal organic development of arnmonaemia, toxaemia, 
and septicaemia, from the undue production and reten- 
tion of ammonia, with other noxious and excremen 
titious matter in the economy, proportionately in- 
crease the tendency to, and promote the inception of 
all other forms of blood-poisoning and adynamia, and 
favor the production and intensify the operation of 
specific contagia or infection of all kinds, with corres- 
ponding zymotic, septic, scorbutic, necraemic, putres- 
cent, mephitic, lithiasic, and other dyscrasic and 
asthenic diseases, manifested in various forms, de- 
grees, and complications of acute and chronic, 
functional and organic, general and local disorders of 
body and mind, according to varying circumstances of 
habits, weather, season, climate, and other morbific 
causes. 

XV. That, as the volatile organic alkali — Am- 
monia is so freely engendered and retained in the 
vital economy from excessive exertion, heat, moisture, 
alcoholic liquors and other noxious ingesta, defective 
oxygenation, alimentation, depuration, and elimina- 
tion, as well as introduced from without in tobacco 
smoke and other forms of malaria from decomposing 
organic matter, impure water, and otherwise, while it 
is solvent, acrimonous, irritant, disorganizing, and 
induces a typhohaernia or putrid dyscrasia, it is very apt 
to accumulate in excess in the blood and body and 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 203 

become the basis, source and origin of the toxemic 
and infectious crasis of all scorbutic, necraernic, 
zymotic, septic, contagious, malignant, putrescent, 
mephitic, and allied diseases, especially of scurvy, 
typhus, typhoid, ship, yellow, congestive, bilious, 
remittent, malarial, puerperal, and other fevers, with 
cerebro-spinal meningitis, small-pox, scarlatina, 
measles, diphtheria, cynanche maligna, erysipelas, 
anthrax, carbunculoid affections, and gangrenous 
sloughing, and phagedenic wounds, ulcers, and similar 
foul conditions generally, with hsemorrhcBal, catarrhal, 
lymphoidal, serous, purulent, and other extravasations, 
as anasarca, haemoptysis, haematemesis, hematuria, 
purpura, bronchorrhcea, leucorrhcea, albuminuria, 
diarrhoea, cholera in its various forms, and other deflux- 
ions, while it engenders an infectious type of an 
ordinarily innocuous disease, ae pneumonia, or pleuro- 
pneumonia, dysentery, metritis, and other occasional 
septic varieties of usually non-contagious affections, 
as well as complicates and intensifies consumption, 
pertussis, gout, rheumatism, eczematous, and all other 
diseases — local and general, from the most insignifi- 
cant and benign to the most malignant. 

XVI. That, excess of ammonia in the blood and 
system is thus the basic, predominant, and prolific 
cause of the most corrupt, contagious, pestilential, 
putrescent, and destructive diseases that afflict man- 
kind and the lower animals, and without which they 
would not develop, or become malignant and infect- 
ious, and that all diseases, benign and contagious, 
local and general may be superimposed upon, or com- 
plicated with, this ammoniacal dyscrasia, according to 
special morbific factors or immediate causes, as for 
instance, the extraneous influences of heat, filth, con- 



204 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

fined or impure air, and malaria in the production of 
superalkalinity of system, congestive, typhus, yellow, 
remittent, enteric, and other fevers; of gestation in 
evolving the diathesis and parturition in exciting puer- 
peral eclampsia and fever; of wounds, bruises, or 
irritations of any kind in arousing erysipelas as well 
as its spontaneous occurrence from the intensity of the 
superalkaline dyscrasia; or of cold and moisture, with 
like general influences, or local irritation of the 
pharynx and air-passages from tobacco and other 
causes in developing diphtheria, cynanche maligna, 
and similar diseases; with the more occult evolution 
of the actively contagious exanthemata — variola, scar- 
latina, and their pestiferous correlatives; besides the 
various intercurrent necrsemic, toxsemic, litheemic, 
uremic, choleraic, and transudative disorders; and 
the more limited local carbunculoid affections and 
grangrenous conditions, — internal and external, the 
septic crasis, disorganizing tendencies and malignancy 
of all which are proportionate to the degree of ammo- 
nsemia. Some of these are entirely, and others in- 
directly dependent upon, and complicated with, this 
basic superalkaline cachexia, the removal of which 
more or less completely subverts the whole disease, 
while its absence prevents the inception thereof. 

XVII. That, as the amrnoniacal basis and infectious 
poison of these zymotic, septic, contagious, pestilential, 
and scorbutic diseases, are largely generated sponta- 
neously within, as well as introduced from without the 
living body special effort should be made to prevent 
the development, neutralize and destroy these primary 
morbific factors with their coexisting and complicating 
specific contagia, as well as subvert and resolve their 
concomitant maladies, and, as they are mainly of 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 205 

an alkaline character, both theory and experience point 
to Acids, antalkaline, and antiseptic substances as the 
specific counteragents and remedies therefor. It 
matters not what the special type of the superalka- 
linity and septicity of the blood, the basic and specific 
treatment is essentially the same in being antalkaline, 
and antiseptic, hence the necessity for acids and their 
correlative antalkaline neutralizing and disinfecting 
agents, the particular form or nature of which will 
depend somewhat upon the special variety of the 
superalkalaMnia, toxaemia, and septicemia, though in 
general the same, and as the acids and their cognates 
are inherently antizymotic, antiseptic, antipyretic, 
disinfectant, resolvent, and depurant, as well as antal- 
kaline, they subserve the various other essential pur- 
poses for the prevention and successful treatment of 
these varied scorbutic, zymotic, septic, contagious, and 
mephitic diseases. 

XVIII. That, in general the most potent antalka- 
line, antizymotic, antiseptic, counteractive, resolving, 
and disinfecting agents to most effectually neutralize 
this superalkalinity of the blood and ammonaemia, 
with their concomitant toxaemia, and poisons, destroy 
the specific contagia and microzymes, subvert their 
morbific effects, depurate the blood and S3 T stem, 
frustrate and resolve such malignant and adynamic 
maladies, are the mineral, vegetal, and animal acids, 
with some of their basic elements and compounds, as 
nitric, hydrochloric, nitro-hydrochloric, phosphoric, 
hydrobromic, sulphuric and sulphurous, carbolic, 
salicylic, lactic, citric, acetic and other vegetal acids, 
with their corresponding bases and compounds, as 
chlorine, chlorides, and chlorates, or chlorine combina- 
tions of iron, soda, and lime more exclusively, and to 



206 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

a certain extent, bromine and bromides, iodine and 
iodides of the same, sulphur, .sulphites, and sulpho- 
carbolates, of soda, salicin and salicylate of soda and 
bismuth, with the juice of limes, lemons, and other 
acid fruits and food, as sour buttermilk, and acid 
albuminoids, usually comprised in an antiscorbutic 
dietary and hygienic regimen. Of these in general, 
the hydrochloric, nitro-hydrochloric, phosphoric, lactic, 
and citric acids, with correlative acid principles and 
aliment, and corresponding bases and compounds 
indicated, are ordinarily the most appropriate and 
specific for the prevention and resolution of these 
septic, contagious, pestilential, mephitic, putrescent, 
and adynamic diseases, both constitutional and local, 
though in some of the latter complications the milder 
and more astringent sulphuric, sulphurous, acetic, 
hydrobromic, sulphocarbolic, and like acids with their 
compounds are most applicable. 

XIX. That, for the general superalkaline, scorbutic, 
septic, toxsemic, infectious, and mephitic dyscrasia, as 
of scurvy, purpura, necrsemia, typhus, ship, remittent, 
and other fevers, and adynamic diseases, with a putrid 
crasis or tendency, even with marked local manifesta- 
tions and complications, as in small-pox, scarlatina, 
diphtheria, typhoid and puerperal fever, erysipelas, 
carbunculoid, gangrenous, and other afiections of a 
like character, the mineral, animal, and vegetal acids, 
especially the nitric, hydrochloric, nitro-hydrochloric, 
phosphoric, sulphuric, citric, lactic, and acetic acids, 
with their equivalent acid compounds, juices, fruits, 
and food, are basic and specific remedies in neutralizing 
the superalkalinity or ammonsemia and toxaemia, 
destroying the specific virus and contagium, toxic, and 
mephitic principles, and underlying cause, drying up 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 207 

the sources, blighting the concomitant poisons, micro- 
zymes, and abnormities, disinfecting the blood and 
body, and resolving the disease altogether. 

XX. That, the neutralization of this ammoniacal 
and superalkaline dyscrasia, by the basic acid and 
antalkaline treatment removes the underlying patho- 
genic cause and resolves the general disorder with the 
concomitant local lesions, whereas without the sub- 
version of the former, the treatment of the latter is 
usually of little or no avail, the local manifestation 
with the constitutional malady running their destruc- 
tive course and becoming intensified and complicated 
according to concurring morbific circumstances, as 
exemplified in septic and adynamic fevers and condi- 
tions generally, with local affections, injuries, and 
ulcerations, the slightest lesion tending to a malignant 
type, heuce the frequent failures of surgical operations, 
and paramount necessity to correct this superalkaline 
dyscrasia by appropriate acid medication and regimen, 
antalkalies, antiscorbutics, and corroborants before, as 
as well as after, to insure the success of operative 
procedures, with the resolution and healing of wounds, 
and local lesions of all kinds. 

XXI. That, while in general, the various acids — 
mineral, animal, and vegetal, with their correlatives, 
are the basic and specific remedies for the primal 
underlying morbific causes and pathological conditions 
of these septic, malignant, contagious, and adynamic 
diseases, in the more complicated inflammatory cases 
thereof they sometimes require to be supplemented 
by more active resolvents as potassium and sodium 
chlorate or their analogues, though guardedly, and 
the elements and compounds, other than ammonia, of 
iodine, bromine, sulphur, as well as chlorine, with in 



208 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

the more asthenic states, the addition of such stimu- 
lants and tonics as oil of turpentine, iron, quinia, 
strychnia, oxygen, peroxide of hydrogen, nitrous 
oxide, and other energetic corroborants. 

XXII. That, in diphtheria, for instance, while the 
acids alone are often sufficient to abort and resolve the 
disease altogether, in the early stage especially, yet, 
from the complex pathology of the malady, a com- 
pound treatment with them as a basis, is usually most 
certain and reliable to overcome the combined abnor- 
mities of the blood, pharynx, and nervous system, con- 
stituting the disease. Thus to neutralize the amnion- 
aemia and toxaemia, destroy the septic and infectious 
matter with the micrococci, disinfect the throat and 
blood, subvert the formation and dissolve the mem- 
branous exudate, and depurate and invigorate the 
entire system at the same time, nitric, hydrochloric, 
or nitro-hydrochloric, with citric, lactic, and phosphoric 
acids are the most useful, though other acids may be 
exhibited in conjunction therewith, or separately as 
their absence and necessity requires. In addition, if 
the exudative tendency is great, the resolvents potas- 
sium and sodium chlorate are efficient adjuvants 
carefully employed in small quantities. For the 
depression and as a haematic, tonic, and antiparalytic, 
muriate of iron, quinia, and strychnia, or the still 
more stimulant phosphoric acid and phosphates or 
lacto-phosphates of the same, may be used in conjunc- 
tion or alternated with the former. To counteract the 
typhoid condition, and for general disinfectant, anti- 
septic, germicidal, stimulant, and other purposes, the 
oil of turpentine is most efficient, exhibited more or 
less freely as indicated by diffusion in the air and more 
direct inhalation, or by the gastro-intestinal canal, as 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. r 209 

well as moderately applied externally to the neck and 
chest if necessary. In conjunction with this treatment 
a corresponding acid regimen should also be adopted 
of lemonade, the juice of limes, lemons, grapes, and 
other acid fruits, with stewed fruit and jellies as 
cranberry, cherries, plums, apples, or apple butter, 
and other tart antiscorbutic vegetals, with such 
corresponding animal food as sour buttermilk, all 
sweetened to taste and taken ad libitum. Indeed, sour 
buttermilk of itself forms a very agreeable, substantial, 
and reliable aliment, as well as efficient solvent and 
medicament through its lactic acid, both locally and 
constitutionally, though cottage cheese, with acidulated 
oysters, eggs, and other albuminoids with vinegar, are 
also applicable, and generally palatable until the 
disease is resolved and health restored. This basic 
acid and correlative treatment, according to my 
experience, most effectually aborts and subdues 
diphtheria with cognate diseases, as it meets all the 
varied indications therein and is prompt and positive 
in both prevention and cure. 

XXIII. That, for the milder diphtheroidal types of 
cynanche, characterized by slight fever, headache, 
loss of appetite, lassitude, depression, congested and 
ulcerated sore throat, scorbutic blood, and general 
malaise, the acid treatment alone with nitro-hydro- 
chloric acid, lemonade, and corresponding acid regi- 
men, is usually very prompt and effective, and will 
often gratify both patient and physician at the speedy 
relief and recovery therefrom, the response thereto 
being too direct and decided to admit of the idea that 
the disease resolved spontaneously. 

XXIV. That, to prevent the further infection, in- 
ception, and extension of diphtheria whenever it 



210 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

appears, the same acid regimen and medication should 
be adopted by all exposed thereto, the former alone or 
with nitro-hydrochloric acid in sweetened water or 
lemonade being prophylactive, and applicable at all 
times to subvert its development, which largely occurs 
from the neglect of appropriate acid alimentation with 
adequate sanitation to remove and avoid all the causes 
of diphtheria, not the least of which is that ever- 
present artificially engendered baneful miasm — tobacco 
smoke, that alkalizes and poisons the blood, irritates 
and inflames the nares, throat, and air-passages, 
depresses the nervous, muscular, and general system 
disorders the nutritive and vital processes, and acts as 
an actively exciting as well as predisposing cause of 
diphtheria with many other abnormities, both local 
and constitutional, and should be suppressed by all 
moral and legal means as a potent cause of disease and 
death in various ways, both directly and indirectly. 

XXV. That, both pathologically and clinically 
diphtheria and croup are distinct diseases though often 
complicated and merging with each other in every 
degree, hence termed diphtheritic croup, the extremes 
being well marked, from the more purely innocuous 
spasmodic, congestive, inflammatory, and membran- 
ous form of the latter to the most malignant and 
infectious variety of the former, requiring in general 
opposite modes of treatment. Thus, in diphtheria, 
mainly by acids, antalkalies, disinfectants, and tonics ; 
in croup, mostly alkalies, antispasmodics, and seda- 
tives, the bromides of sodium and potassium, or, even 
in some cases, ammonium, and iodoform, being 
specially indicated therein, as well as in whooping 
cough, with their analogues, from their local and 
general anaesthetic, antispasmodic, and resolvent 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 211 

effects; while hydrobromic acid is better adapted to 
the sthenic types of the complex varieties, which 
necessitate a mixed treatment with the sedative or 
tonic acids, neutral salts and corresponding remedies, 
according to the special sthenic or asthenic character, 
tendency, and complications of the local and constitu- 
tional affections. 

XXVI. That, the same general acid and correlative 
basic and specific remedies, principles of treatment, 
and prophylaxis apply in all allied diseases with diph- 
theria, as in the acute stage and active phlegmonous 
form of cynanche, and scarlatina, the mineral, and 
vegetal acids, with potassium and sodium chlorate, or 
their analogues, are more exclusively applicable, while 
in the adynamic and putrid stages or varieties of 
anginose and other affections, it is better to omit or 
reduce to a minimum the latter according to the 
degree of local inflammation and exudation, and add 
the muriates of iron, quinia, and strychnia, alternating 
with the phosphates or lacto-phosphates of the same, 
with ol. terebinth, more or less freely according to 
necessity, acidulated coffee, and other non-alcoholic 
stimulants as being far better in these and other 
diseases than spiritous liquors. In the active febrile 
and inflammatory stage of small-pox, the hydrochloric 
and nitro-hydrochloric, with the animal and vegetal 
acids are also the basic remedies, aided by the chlorates 
or citrates of potassium and sodium or other salines, 
as indicated, but which should be withdrawn as the 
sthenic condition declines, and be combined with, or 
substituted by the muriates of iron and quinia, or 
strychnia with the acids, in conjunction alternately 
with phosphoric acid and its compounds of the same 
with lime in the adynamic conditions, and with sul- 



212 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

phuric acid and its analogues, and oil of turpentine 
freely in the typhoid and haemorrhagic states. The 
same general treatment is applicable in all the exan- 
themata. In septicaemia and puerperal fever, active 
support is required from the beginning, hence the 
nitromuriatic acid in water or lemonade, and muriatic 
acid with muriates of iron and quinia, with moderate 
doses of potassium and sodium chlorate combined, 
and free stimulation with oil of turpentine, strong 
acidulated coffee, and other non-alcoholic corroborants, 
are most appropriate. While in its analogue, — 
erysipelas, the same nitro-hydrochloric acid, and 
hydrochloric acid with the chlorides of iron and 
quinia, and ol. terebinth, are also markedly efficient, 
the saline resolvents not being usually required therein 
except in the more phlegmonous form. In carbuncu- 
loid affections the acids and chlorates in the more in- 
flammatory states, with the tonic chlorides in the 
adynamic conditions are actively resolvent and re- 
storative. In typhus, ship, remittent or malarial, and 
other asthenic fevers without severe local complica- 
tions, the nitric, muriatic and nitromuriatic, phospho- 
ric, citric, and other acids are actively efficient, though 
the concomitant adynamia may be more readily 
overcome by the additional stimulus of quinia, strych- 
nia, oil of turpentine, acidulated or plain coffee, and 
other non-alcoholic corroborant and tonic agents. In 
all septic, infectious, and mephitic conditions, Tax 
water forms a mild stimulant, disinfectant, alterative 
menstruum for the stronger remedies, while lemonade 
and sour buttermilk are generally useful as antalkaline, 
antiseptic, antipyretic, refreshing, nutrient and restora- 
tive drinks. In the more sthenic stages or varieties of 
these with other diseases, it is probable that hydro- 
bromic acid will be very efficient, especially in irritable 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 213 

and inflammatory anginose and gastro-intestinal affec- 
tions or complications, as in scarlet and yellow fever, 
and gastro-enteritis, phlegmonous, traumatic, and other 
fevers, with cognate abnormities, though its anaesthetic 
and sedative properties contraindicate and limit its 
application in diseases essentially asthenic or with an 
adynamic tendency. In all such diseases correspond- 
ing appropriate local and external applications are 
useful adjuvants to the general treatment. Thus, 
with all diseases of this same general class, the mineral, 
animal, and vegetal acids, or the acid medication and 
regimen form the specific treatment, to be pushed ad 
saturandum in all cases to overcome the basic superalka- 
linity and concomitants, specially adapted and supple- 
mented by other remedies as indicated by the varied 
conditions and complications thereof. 

XXVII. That, when stimulants and tonics are 
required in these and other diseases, phosphoric acid, 
oil of turpentine, valerian, coffee, tea, coca, oxygen, 
peroxide of hydrogen, nitrous oxide, quinia, strychnia, 
and their correlatives, are far better than spirituous 
liquors in any form. The oil of turpentine is espe- 
cially efficient as a substitute for alcohol, being 
superior thereto in many respects, and as a rapid, 
diffusible, and more permanent stimulant, to the 
heart, circulation, and system in general, as well as 
a potent, antizymotic, antiseptic, haemostatic, discu- 
tient, alterative, secernant, diaphoretic, diuretic, 
laxative, disinfectant, depurant', and restorative, while 
it can be readily and freely exhibited by involuntary 
inhalation, without dosing the stomach or risking the 
acquisition of bibulous habits. Besides, by its diffusion 
in the air it engenders ozone, and acts as a general 
disinfectant and germicide, protective of those exposed 



214 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

to malarious and contagious influences. It may also 
be required by the stomach and bowels, and should 
be freely used to disguise the taste and smell of 
alcoholic liquors whenever they are employed, which 
should be as seldom as possible. Coffee is also a 
valuable disinfectant, antiperiodic, antiseptic, febri- 
fuge, digestive, cholagogue, stimulant, and tonic, 
useful in malarial and low fevers, infectious and ady- 
namic conditions, and as a counteractive to the 
depression from, and a substitute for, alcohol. Be- 
sides, it forms an excellent menstruum for disguising 
the taste of quinia and other nauseous drugs, while 
with lemon juice and other acids it is actively reme- 
dial and restorative in scorbutic, malarial, septic, 
contagious, and other diseases, and with milk and 
sugar a pleasant nutrient supporting drink, that in 
various forms and combinations may often be medici- 
nally employed with advantage in lieu of more 
dangerous and expensive remedies. Oxygen, per- 
oxide of hydrogen, nitrous oxide, and other invigorat- 
ing agents indicated are also far better than alcohol 
in all essential respects without any of its obnoxious 
effects. 

XXVIII. That, at the best, alcohol is but a tem- 
porary stimulant in very small doses for a brief period, 
and permanent sedative, inebriant, narcotic, and 
stupefacient, depressing, relaxing, and paralyzing in 
large or frequent small doses, the very opposite of 
tonicity and invigoration as amply demonstrated in 
the familiar phenomena of intoxication or poisoning 
therewith. In the former period of excitement it thus 
affords but temporary reactive excitation that soon 
subsides and requires its frequent repetition in dimin- 
ishing doses to continue its excitable effects, rather 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 215 

than in increasing and sedative quantities, to thus 
avoid exhausting or overpowering the inherent vital 
excitability upon which its stimulant effects depend, 
as it gives nothing to the system and stimulates only 
by exciting vital reactive effort to throw it off and 
resist its poisonous influence, so frequently exhibited 
in drunkenness. Hence, alcohol in every form is 
inadequate as a permanent stimulant in any case 
requiring prolonged stimulation and support, and is 
only adapted in small doses for the treatment of 
temporary states of depression, rather than for severe 
and prolonged illness, and not at all in the treatment 
of chronic disease in which permanent stimulants and 
tonics are required, while it is not preventive but 
productive of disease in general, and has no property 
or application whatever as a food or beverage. 

XXIX. That, as in common with all other zymotic, 
septic, and allied diseases, ammonaemia and super- 
alkalinity of the body is the basis of that destructive 
pestilence of tropical climes — yellow fever, the acid 
treatment and regimen with the mineral, animal, and 
vegetal acids, the nitric, hydrochloric, nitro-hydro- 
chloric, phosphoric, citric, lactic, and acetic acids 
more particularly, with phenic, sulphurous, sulpho- 
carbolic, and salicylic acids, and their cognates, 
chlorine, chlorides, and chlorates, hydrarg. bichlorid, 
chlorinated soda, bromides, sulpho-carbolates, salicy- 
lates, other than ammonia, lime and lemon juice, 
vinegar, sour buttermilk, and the acid fruit and food 
generally, with the oil of turpentine, and the more 
vitalizing oxygen, peroxide of hydrogen, nitrous 
oxide, and other non-alcoholic stimulants, alteratives, 
resolvents, and restoratives, as specially indicated, 
promise to prove specific therefor as in all correlative 
diseases. 



216 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

XXX. That, as supplementary to this general acid 
medication in all scorbutic, zymotic, septic, infectious, 
mephitic, and cognate diseases — both local and 
systemic, there should be a corresponding acid dietary 
with the juice of limes, lemons, oranges and other 
acidulous fruit, jellies of cranberries and similar acid 
berries, stewed cherries, apples, plums, prunes, 
tomatoes, and like antiscorbutic vegetals, with ripe, 
pulpy, succulent, juicy, tart fruit, like peaches, pears, 
apricots, grapes, tamarinds, etc., and the more sub- 
stantial nitrogenized drink and food presented in 
sour buttermilk and its analogues, all sweetened to 
taste. Acidulated oysters, eggs, and other concen- 
trated nitrogenous food with vinegar, lemon juice, and 
like acids, pickled tripe, soused pig's feet, and other 
acid albuminoids, and peptonized food are also most 
applicable and nutritious therein. 

XXXI. That, as in general this acid medication 
and alimentation is too secernant and laxative in those 
cases in which there is undue secretion and defluxion 
from the bowels and other parts, as in diuresis, 
diarrhoea, typhoid fever, cholera, and like affections, 
the more astringent acids, bases, compounds, and 
regimen, are most appropriate according to special 
indications, as muriatic, phosphoric, plain or aromatic 
sulphuric acid, sulphurous, carbolic, acetic, and other 
constringing acids, with chloride, bromide, or phos- 
phate of iron and lime, or sulphate of iron, sulpho- 
carbolate of soda, and like compounds, with corres- 
ponding acidulous fruit juices, and food, as quince, 
banana, etc., and such astringent, tonic, nutrient 
drinks as tea with milk and sugar, cold as well as 
hot tea being very grateful and restorative in diar- 
rhoea and choleraic affections. Milk with lime water 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 217 

or sulphite of lime, bicarbonate or bisulphite of soda, 
or peptonized milk and other food, are still more 
nutrient, emollient, germicidal, and tonic therein. 
Tea and milk at any temperature, separately or 
together are specially indicated in intestinal fluxes 
and cholera, as they are refreshing, nutrient, consti- 
pating, supporting, promotive of absorption and 
restitution of the lost fluid, while they may be taken 
as freely and frequently as desired, though small 
quantities at a time are preferable, being far more 
remedial and nourishing than cold water alone, which 
is so beneficial in choleraic affections, though hot 
drinks are usually most applicable, particularly in the 
collapsed conditions. Tea sweetened and without 
milk, is a useful vehicle for, and adjuvant of plain or 
aromatic sulphuric, acetic, and other astringent acids, 
especially applicable in enteric fever, cholera infan- 
tum, cholera, serous, hemorrhagic, and other pro- 
fluvia, in which these constringing acids are very 
efficacious. Also, as indicated, in depression and 
defluxions, other stimulants and astringents may be 
added to, or given separately and followed with a 
draught of tea, as capsicum, krameria, valerian, 
compt. tinct. of cinchona, sulphuric ether, spirits of 
camphor, turpentine, etc., to restrain the flow and 
excite reaction, especially in prostration and collapse 
from choleraic and other drains. 

XXXII. That, in diarrhoea, cholerine, and choleraic 
defluxions, the astringent acids and their compounds 
as plain or aromatic sulphuric acid, phosphoric acid 
with its compounds of iron and lime, siaiple, aro- 
matized or camphorated vinegar, or a combination of 
acetate of lead, opium, camphor, and carbolic acid in 
pill by the stomach, and plumbi acetas with opium in 



218 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

suppository by the rectum, in doses before stated, 
with corresponding antalkaline, antizymotic, cons- 
tringing acidulous drinks, remedies, and regimen 
elsewhere specified are in general very efficient in 
correcting the systemic and gastro-intestinal disorder 
and arresting the profluvia. 

XXXIII. That, in the depression, collapse, and 
typhoid condition of enteric fever, cholera, and all 
other diseases, the oil of turpentine by free inhalation 
as well as by the mouth and rectum, and externally, 
is powerfully stimulant in exciting reaction and 
restoration. Nitrous oxide is a still more potent 
stimulant, revivifier, and tonic, and will doubtless 
excite reaction as promptly in cholera as in other 
asphyxiated and collapsed conditions, as well as 
counteract the disease in general. Oxygen and peroxide 
of hydrogen are also applicable for the same purpose, 
but are not so stimulant as nitrous oxide, which is a 
superior exhilarant, invigorant, and restorative that 
will no doubt prove most efficacious in cholera as in 
other adynamic disorders. Hypodermic injections of 
camphorated ether, strychnia, and other reactives, with 
sub-cutaneous or intravenous injections of artificial 
serum, and transfusion of blood, are valuable restora- 
tives. Warm clothing, and stimulant applications to the 
surface of turpentine, allium, capsicum, heat, and 
other exciting agents are also beneficial. 

XXXIV. That, in general, in all zymotic, septic, 
infectious, febrile, mephitic, and cognate diseases, 
with the internal medication external application 
of acidulous and disinfecting agents are also important, 
as nitro-hydrochloric, muriatic, carbolic, salicylic, 
and other acids, or vinegar, with chlorine water, 
chlorinated soda, etc., properly diluted, and applied 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 219 

to the surface, are very useful in malignant and con- 
tagious fevers, malarial, infectious, and mephitic con- 
ditions, varying according to the special type of the 
disease, as chlorine water, disinfecting baths, or solu- 
tions of chlorinated soda and lime, sulphurous or 
carbolic acid, or sulphocarbolate of soda, vinegar, etc., 
in small-pox, scarlatina, and other exanthemata, while 
the nitric, hydrochloric, nitro-muriatic, and cognate 
acids are better in bilious, typhus, yellow, and other 
fevers and mephitic states, applied either in general 
bathing, foot or sponge baths, simple lavements, or 
stronger direct applications, according to the character 
of the disease, and emergency of treatment; such 
agents as oil of turpentine, capsicum, allium, mustard, 
and like excitants with heat particularly, being more 
applicable in cholera and similar adynamic conditions. 
XXXV. That, matter, force, and natural law, are 
the same always and forever, and life and disease, like 
fire, are dependent upon definite primal conditions, and 
originate spontaneously at all times and places alike 
whenever the essential factors or concurring circum- 
stances are present. Hence, the most malignant and 
contagious, as well as the less infectious, with all 
innocuous diseases, originate de novo at any time, 
anywhere, whenever the pathogenic factors are favor- 
able for their development, which are dependent upon 
special conditions peculiar to each disease, and not 
upon time or place, and will thus originate sponta- 
neously at any time, anywhere, whenever the necessary 
morbific elements or conditions are sufficiently active, 
the specific nature of which it is the duty and should 
be the object of scientists to discover, avert, neutral- 
ize, decompose and destroy. 



220 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

XXXYI. That, contagious with non-infectious 
diseases are primarily of a chemico-organic and 
bio-dynamic, rather than microzymic origin, micro- 
organisms or the so-called germs being concomitants 
and sequential, or of secondary development, their 
evolution and vigor being dependent upon an ammo- 
niacal, corrupt, and degenerate state of the fluids and 
solids of the vital economy, carbonic acid, water, and 
ammonia, being the primal essentials for their origin, 
development, and activity, filth, and decomposing 
organic matter or putrefaction, breeding them as well 
as engendering contagia, ptomaines, with other toxic 
agents, and giving out septic poisons and mephitic 
miasms within, as well as without the living organism. 

XXXVII. That, as Ammonia dissolves and decom- 
poses the corpuscles of the blood and plastic compo- 
nents of the vital tissues, induces a state of superalka- 
laemia, toxaemia, septicaemia and corruption, and 
engenders micro-organisms with various poisonous 
and infectious principles within the living economy, 
it is the basic pathogenic material and morbific factor 
in causing scorbutic, necraemic, zymotic, septic, con- 
tagious, pestilential, mephitic, colliquative, and allied 
diseases, and that by its prevention, subversion, 
neutralization, removal, or destruction, the primal 
source of these toxic, infectious, and morbific agents, 
maladies, and microzymes, is overcome, and the whole 
train of pestiferous sequelae counteracted and destroyed, 
which can be most effectually accomplished by the 
acid antalkaline, antiscorbutic, antizymotic, antiseptic, 
disinfectant, depurant, resolvent, stimulant, tonic, and 
sanative medication and alimentation previously 
specified. 



DIPHTHERIA, TYPHOID, AKD ALLIED DISEASES. 221 

XXXVIII. That for the most perfect protection 
against disease of all kinds, whether casual, endemic, 
epidemic, infectious, contagious, or innocuous, besides 
the purification of surroundings, and avoidance of 
pernicious ingesta, particularly of those baneful 
agents — tobacco and alcohol, with vicious habits and 
practices, efficient means should be adopted to insure 
personal cleanliness, purity, and healthful vigor of the 
whole system, as essential to guard against the spon- 
taneous origin, as well as acquisition and communica- 
tion of contagious, with the development of all other 
diseases. This personal sanitation should be compulsory 
wherever possible, as well as voluntary, so as to 
disinfect, depurate, and purify every molecule, cell, 
part and particle of the entire economy, interior and 
exterior, the mere purification of the surface of the 
body being as insufficient as the cleansing of the outside 
of a fount of corruption steadily generating within, 
and sending forth through every pore pestiferous 
poison. So likewise, the living organism engenders 
and exhales poisonous and morbific effluvia, that 
necessitates its constant depuration within, throughout, 
and from the entire system, to prevent the development 
or retention, and destroy ab initio the internal produc- 
tion of toxic, infectious, and mephitic matter, which 
uncontrolled is apt to prove a bodily source and fons 
et origo of corruption, disease, pestilence, and death 
to the individual and community. 

XXXIX. That, in quarantine, barracks, prisons, 
hospitals, and elsewhere, wherever authority prevails, 
this personal disinfection and purification of the blood 
and body or entire vital economy inside and outside, 
should be enforced at all times as well as during 
epidemics, exposure, and -special periods of danger, 



222 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

particularly of filthy people and those coming from 
infected places, or exposed to extraneous contagion, 
by this acid antalkaline, disinfectant, antiseptic, anti- 
zymotic, and corroborant regimen and medication, as 
the most positive safeguard in general against con- 
tagious and pestilential, with ordinary diseases. But 
for the greatest success in this bodily purification and 
prophylaxis against disease, special adaptation of the 
various disinfecting and sanitary agents, especially of 
aliment, must be made according to the particular 
type and tendency of the infection or epidemic, with 
personal peculiarities and conditions, in unison with 
the varied character, tendency, and complication of 
these diverse maladies, which though depending upon 
the same basic superalkaline dyscrasia, yet need varied 
special acidulous, antalkaline, antitoxic, neutralizing, 
disinfectant, depurative, remedial, and dietetic treat- 
ment as before specified. 

XL. That, as most essential to insure the greatest 
vigor, purification and protection of the vital economy 
from impurity, contagia and disease of all kinds, 
with other essentia of alimentation, there must be 
perfect purity of the inspired air, the atmosphere being 
the great reservoir of the supreme vitalizer, invigor- 
ant, disinfectant, tonic, and restorative — oxygen, that 
constantly penetrates, enlivens, transforms, and 
animates, as well as disintegrates and depurates, every 
blood-corpuscle, cell, and fibre of the living organism, 
any interference with this primal process of aeration, 
necessarily proportionately induces asphyxia, toxico- 
sis, disease, decline, and death. Hence, as indispens- 
able for the preservation and restoration of health, the 
use of, or exposure to, all noxious agents that pollute 
the atmosphere, or malaria, in every form, must be 
carefully avoided, particularly the poisonous vapor 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 223 

and smoke of tobacco, obnoxious at all times and 
especially dangerous during epidemics of diphtheria, 
cholera, typhus, yellow fever, typhoid and cognate 
diseases, even to those accustomed to it, and so much 
the more to the many unaccustomed and supersuscep- 
tible to its noxious effects. What folly it is then to 
prate about the danger and ill effects of malaria, with 
the necessity for ventilation, pure air and cleanliness, 
while befouling and permitting the atmosphere almost 
everywhere to be corrupted by this pernicious mias- 
matic tobacco smoke that poisons the blood and bodies, 
and saps the vital power of all who inhale it. What can 
be expected of the ignorant masses with regard to sani- 
tation in this respect, when even their sanitary 
guardians and the professed teachers of hygiene (?) 
themselves thus actively engender this poisonous 
miasm and pollute the air with this potent nicotian 
enemy of health and life ? Well may we parody the 
despairing cry of the perishing mariner on the sea, of 
" Water, water everywhere, but none to drink," by the 
corresponding one of Air, air everywhere, but none to 
breathe, uncontaminated with the noxious tobacco 
miasm, though the latter cannot be rejected like the 
former, but must perforce be inhaled nolens volens 
with all its pestiferous adulterants, thus coercively 
taking with it into the lungs, blood, and system, this 
baneful compound miasm of degradation, disease, 
pestilence, and death to the innocent as well as guilty. 
To parody Goldsmith, it may be truly said 

111 fares that land to nicotian miasm a prey, 
Where tobacco blights and human beings decay. 

Hence avoidance of all deleterious agents and habits, 

with purification of the air, purification of the body in 

its entirety— internal and external, are basic essentia of 

health and life, while common sense, decency, equity, 



224 BASIC PATHOLOGY AND SPECIFIC TREATMENT OF 

and self-preservation, instigate to the suppression of 
this poisonous artificial tobacco, with all natural 
miasmata, as far better than trying to subvert their 
evil effects, which, with the consequent waste of time, 
means, and vital energy, degeneration, suffering, and 
destruction of health and life, would be entirely 
averted if the former were duly obviated. 

XLL That, finally, as the facts and principles herein 
presented, are based upon, and in direct accord with, 
chemistry, physiology, aetiology, pathology, hygiene 
and therapeutics, they are believed to be correct in 
science and truth, and if properly applied cannot fail 
to largely prevent, subvert, resolve and cure these 
formidable pestilential, zymotic, septic, infectious, 
contagious, malarial, mephitic, putrescent, and colli- 
quative maladies, with the minor scorbutic, necrsemic, 
and adynamic disorders and complications, that pre- 
vail so extensively throughout the world and afflict 
and destroy mankind with the lower forms of life, 
and consequently, save from unnecessary sickness, 
suffering, and premature death, with all their con- 
comitant misery, thousands of human beings and 
inferior animals — for they are interminably interlinked, 
who would otherwise suffer and perish therefrom. 
Therefore, to this desirable end, it is hoped that these 
views will be subjected to the severest practical test 
in the prevention and treatment of all such diseases, 
in quarantine, hospitals, and elsewhere, in public and 
private — human and veterinary — practice, to most 
fully determine their true value and extend their 
benefits as widely as possible to both mankind and 
the inferior creatures, for ammonaemia and superalka- 
linity with their toxemic, contagious, colliquative, 
and pestilential concomitants occur, and acid, antal- 
kaline, antiscorbutic, antiseptic, and disinfectant 



DIPHTHERIA, TYPHOID, AND ALLIED DISEASES. 225 

measures are required in all for the preservation and 
restoration of health. This is exemplified in the 
varied forms and degrees of typhoid, necraemic, 
toxsemic, contagious, colliquative, pestilential, gan- 
grenous, putrescent, and allied diseases — constitu- 
tional and local, both in man and the lower organisms, 
all of which are of the same general nature, though 
variously manifested and complicated by t special 
modifying circumstances and specific contagia, yet 
originate from, and dependent upon, the same general 
basic ammoniacal or superalkaline condition, and 
scorbutic, septic, and corrupt dyscrasia, with the same 
general process of disorganization of the blood and 
body decomposition and rottenness, with their con- 
comitant mephites, poisons, infection, and micro- 
organisms, and which, from their general similitude 
and predominant symptoms in some of the more 
malignant varieties, have been aptly termed the 
plague, malaria, black jaundice, black vomit, black 
tongue, black measles, black small-pox, black disease, 
black death, cholera, and otherwise designated as 
indicative of a like general typhohsemia, disorganiza- 
tion, and dissolution, from one common solvent 
decomposing alkaline agent — Ammonia, of intrinsic 
and extraneous origin, superinduced by and compli- 
cated with, various systemic and adventitious causes 
previously indicated, with often lack of fresh, succu- 
lent, acidulous, antalkaline, antiscorbutic, antiseptic, 
counteracting food, so common with mankind and the 
inferior creatures, as they are closely affiliated patho- 
logically and therapeutically, as well as physiologically 
and hygienically, the general laws of life, health, 
disease, and death, being the same throughout the 
entire animated creation. 



